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At least 793 records · Page 44Linked to original sources

Operative risk of mitral valve replacement: discriminant analysis of 1329 procedures.

The influence of 34 variables on the operative mortality rate for isolated mitral valve replacement (MVR) was assessed by univariate and multivariate logistic regression analysis. The physiologic lesions were classified as stenosis (20%, operative mortality rate 8 +/- 1%), regurgitation (44%, operative mortality rate 13 +/- 2%), and mixed (34%, operative mortality rate 8 +/- 1%). Functional class (NYHA), previous myocardial infarction, and hepatic dysfunction were powerful independent clinical determinants of operative mortality (p less than .001), along with age at operation and emergency operation (p = .001, p = .04). Concomitant coronary artery bypass grafting or tricuspid annuloplasty, angina, ischemic etiology, and physiologic lesion were not significant independent determinants of operative risk. Interestingly, year of operation, prosthetic valve dysfunction, and previous cardiac surgery had no important effect on operative mortality. Early operative risk for MVR was related to preoperative cardiac and hepatic function. Prior myocardial infarction substantially increased the risk even if the mitral valve disease was not ischemic in origin. Increased operative mortality rate in the subgroup with mitral regurgitation was related to advanced left ventricular failure and myocardial infarction rather than the etiology of the mitral regurgitation. These clinical factors coupled with more refined measurements of left ventricular systolic pump function (independent of loading conditions) should permit more intelligent decision making regarding the optimal timing of MVR, at least in terms of early operative risk.

Adult↗

Adaptive Behavior Scale: development as a diagnostic tool via discriminant analysis.

The multidimensional nature of behavior often causes a dilemma for the diagnostician who must interpret inconsistent behavior. Three classifications of 6- through 12-year-old children were evaluated on the public school version of the Adaptive Behavior Scale by their teachers. Of the 388 nonretarded, 115 EMR, and 85 TMR children, 86 percent were correctly identified via 12-variable classification functions. The results indicate that further development of an adaptive behavior instrument would be desirable as a cost-efficient and powerful diagnostic tool.

Child↗