Abstract P224: Completeness of Revascularization Predicts Long-Term Survival Benefit in CABG Surgery
Bibliographic record
Abstract
Objectives: The primary objective of this study was to examine the effect of complete vs. incomplete revascularization in CABG surgery on long-term mortality. The secondary objective of this study was to examine the effect of variable grafting strategies on long-term mortality. Methods: All consecutive CABG surgeries performed at a single tertiary care center between 1995-2007 were reviewed. Long-term survival rates were compared among patients based on completeness of revascularization, the use of no arterial graft (all saphenous vein), single arterial graft, and multiple arterial grafts. Groups were also stratified based on the type of arterial grafts used (bilateral internal mammary arteries (BIMA) vs. multiple arterial grafts with only one IMA). Cox proportional Hazards ratio models were generated to adjust for differences in clinical presentation between the CABG groups. Results: A total of 8977 isolated CABG operations were preformed at our institution during that period. These patients were followed for a median time of 3.5 years (IQR=1.1-6.4). In this patient population, incomplete revascularization predicted an increased risk of mortality (HR=1.25; CI=1.12-1.39). A single arterial graft was performed in the majority of patients (63%; n=5637) with 28% of patients (n=2532) receiving multiple arterial grafts. Patients who received multiple arterial grafts were more likely to be younger, male, and undergo non-urgent surgery. After adjusting for these differences, patients who received an arterial graft (LIMA, RIMA, or radial) were shown to have improved survival when compared to patients who did not (HR=0.74; CI=0.65-0.83). Among patients who received multiple arterial grafts, percent survival for patients with BIMA grafts at 10 years was 70.4% compared to 66.1% for patients with single arterial grafts. Furthermore, patients who received BIMA grafts had the lowest predicted mortality among arterial graft patients when compared to patients who did not receive an arterial graft (HR=0.63; CI=0.51-0.77). Conclusions: We were able to show that after adjusting for differences in clinical presentation, both completeness of revascularization and BIMA grafting are strong independent predictors of long-term survival among CABG patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".