Imperial College London
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Professor Konstantinos Dimopoulos

Faculty of Medicine, National Heart & Lung Institute

Professor of Practice (Adult Congenital Heart Disease)
 
 
 
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Contact

 

+44 (0)20 7352 8121 ext 82771k.dimopoulos02

 
 
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Location

 

Chelsea WingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Constantine:2021:10.1016/j.jacc.2021.04.096,
author = {Constantine, A and Costola, G and Bianchi, P and Chessa, M and Giamberti, A and Kempny, A and Rafiq, I and Babu-Narayan, S and Gatzoulis, M and Hoschtitzky, A and Shore, D and Aw, T-C and Ranucci, M and Dimopoulos, K},
doi = {10.1016/j.jacc.2021.04.096},
journal = {Journal of the American College of Cardiology},
pages = {234--242},
title = {Enhanced assessment of perioperative mortality risk in adults with congenital heart disease},
url = {http://dx.doi.org/10.1016/j.jacc.2021.04.096},
volume = {78},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundIn-hospital mortality is a rare, yet feared complication following cardiac surgery in adult congenital heart disease (ACHD). A risk score, developed and validated in ACHD, can be helpful to optimize risk assessment.ObjectivesTo assess the performance of EuroSCORE II components and procedure-related Adult Congenital Heart Surgery (ACHS) score, identify additional risk factors, and develop a novel risk score for predicting in-hospital mortality after ACHD surgery.MethodsWe assessed perioperative survival in patients >16 years undergoing congenital heart surgery in a large tertiary center between 2003 and 2019. A risk variable derived PErioperative ACHd (PEACH) score was calculated for each patient. Internal and external validation of the model was undertaken, including testing in a validation cohort of patients operated in a second European ACHD center. ResultsThe development cohort comprised 1782 procedures performed during the study period. Re-sternotomy was undertaken in 897(50.3%). There were 31(1.7%) in-hospital deaths. The PErioperative ACHd (PEACH) score showed excellent discrimination ability (AUC 0.88, 95%CI:0.83-0.94), and performed better than the ACHS score in our population (ACHS AUC 0.69, 95%CI:0.6-0.78, p=0.0003). A simple 3-tiered risk stratification was formed: PEACH score 0 (in-hospital mortality 0.2%), 1-2 (3.6%), ≥3 (17.2%). In a validation cohort of 975 procedures, the PEACH score retained its discriminative ability (AUC 0.75, 95%CI:0.72-0.77) and was well calibrated (Hosmer Lemishow 2 goodness-of-fit p=0.55). There was agreement in expected and observed perioperative mortality between cohorts.ConclusionsThe PEACH score is a simple, novel peri-operative risk score developed and validated specifically for ACHD patients undergoing cardiac surgery. Condensed abstract:The PEACH score is a simple, novel peri-operative risk score developed and validated specifically for ACHD patients undergoing cardiac surgery. In this study, we assesse
AU  - Constantine,A
AU  - Costola,G
AU  - Bianchi,P
AU  - Chessa,M
AU  - Giamberti,A
AU  - Kempny,A
AU  - Rafiq,I
AU  - Babu-Narayan,S
AU  - Gatzoulis,M
AU  - Hoschtitzky,A
AU  - Shore,D
AU  - Aw,T-C
AU  - Ranucci,M
AU  - Dimopoulos,K
DO  - 10.1016/j.jacc.2021.04.096
EP  - 242
PY  - 2021///
SN  - 0735-1097
SP  - 234
TI  - Enhanced assessment of perioperative mortality risk in adults with congenital heart disease
T2  - Journal of the American College of Cardiology
UR  - http://dx.doi.org/10.1016/j.jacc.2021.04.096
UR  - https://www.sciencedirect.com/science/article/pii/S0735109721051378?via%3Dihub
UR  - http://hdl.handle.net/10044/1/89641
VL  - 78
ER  -
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