ArticleThe Annals of thoracic surgery2018
Utility of Biomarkers to Improve Prediction of Readmission or Mortality After Cardiac Surgery.
Article in The Annals of thoracic surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prediction models for hospital readmissions in patients with heart disease: a systematic review and meta-analysis.BMJ open · 2021Pooled it
- Risk Stratification for Postoperative Mortality in Cardiac Surgery: "Quo Vadis"?Medicina (Kaunas, Lithuania) · 2026Review
- Fibroblast Growth Factor 23 Is a Strong Predictor of Adverse Events After Left Ventricular Assist Device Implantation.Journal of cardiovascular development and disease · 2025Article
- Clinical Value of Bioactive Adrenomedullin and Proenkephalin A in Patients with Left Ventricular Assist Devices: An Observational Study.Journal of clinical medicine · 2025Article
- Derivation and validation of predictive indices for cardiac readmission after coronary and valvular surgery - A multicenter study.American heart journal plus : cardiology research and practice · 2023Article
- Diagnostic accuracy of copeptin and NT-proBNP level in predicting mortality and postoperative prognosis in coronary surgery with respect to EuroSCORE risk.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2022Article
- Selective biomarkers for inflammation and infection are associated with post-operative complications following transperineal template prostate biopsy (TTPB): a single-centre observational clinical pilot-study.European journal of medical research · 2022Observational
- Can diverse population characteristics be leveraged in a machine learning pipeline to predict resource intensive healthcare utilization among hospital service areas?BMC health services research · 2022Article
- Proenkephalin A and bioactive adrenomedullin are useful for risk prognostication in cardiac surgery.Frontiers in cardiovascular medicine · 2022Article
- Improving the prediction of long-term readmission and mortality using a novel biomarker panel.Journal of cardiac surgery · 2021Article
- Cardiac Biomarkers Associated With Hospital Length of Stay After Pediatric Congenital Heart Surgery.The Annals of thoracic surgery · 2021Article
- ST2 Predicts Risk of Unplanned Readmission Within 1 Year After Pediatric Congenital Heart Surgery.The Annals of thoracic surgery · 2020Article
- Association of plasma-soluble ST2 and galectin-3 with cardiovascular events and mortality following cardiac surgery.American heart journal · 2020Article
- Cardiac Biomarkers Predict Long-term Survival After Cardiac Surgery.The Annals of thoracic surgery · 2019Article
- The Association between Cytokines and 365-Day Readmission or Mortality in Adult Cardiac Surgery.The journal of extra-corporeal technology · 2019Article
- Using Soluble ST2 to Predict Adverse Postoperative Outcomes in Patients with Impaired Left Ventricular Function Undergoing Coronary Bypass Surgery.Medicina (Kaunas, Lithuania) · 2019Article
- Urine complement activation fragments are increased in patients with kidney injury after cardiac surgery.American journal of physiology. Renal physiology · 2019Article
- Biomarkers improve prediction of 30-day unplanned readmission or mortality after paediatric congenital heart surgery.Cardiology in the young · 2019Article
- Are Urinary Biomarkers Better Than Acute Kidney Injury Duration for Predicting Readmission?The Annals of thoracic surgery · 2019Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundHospital readmission within 30 days is associated with higher risks of complications, death, and increased costs. Accurate statistical models to stratify the risk of 30-day readmission or death after cardiac surgery could help clinical teams focus care on those patients at highest risk. We hypothesized biomarkers could improve prediction for readmission or mortality.
methodsLevels of ST2, galectin-3, N-terminal pro-brain natriuretic peptide, cystatin C, interleukin-6, and interleukin-10 were measured in samples from 1,046 patients discharged after isolated coronary artery bypass graft surgery from eight medical centers, with external validation in 1,194 patients from five medical centers. Thirty-day readmission or mortality were ascertained using Medicare, state all-payer claims, and the National Death Index. We tested and externally validated the clinical models and the biomarker panels using area under the receiver-operating characteristics (AUROC) statistics.
resultsThere were 112 patients (10.7%) who were readmitted or died within 30 days after coronary artery bypass graft surgery. The Society of Thoracic Surgeons augmented clinical model resulted in an AUROC of 0.66 (95% confidence interval: 0.61 to 0.71). The biomarker panel with The Society of Thoracic Surgeons augmented clinical model resulted in an AUROC of 0.74 (bootstrapped 95% confidence interval: 0.69 to 0.79, p < 0.0001). External validation of the model showed limited improvement with the addition of a biomarker panel, with an AUROC of 0.51 (95% confidence interval: 0.45 to 0.56).
conclusionsAlthough biomarkers significantly improved prediction of 30-day readmission or mortality in our derivation cohort, the external validation of the biomarker panel was poor. Biomarkers perform poorly, much like other efforts to improve prediction of readmission, suggesting there are many other factors yet to be explored to improve prediction of readmission.
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