NDLI: Evidence-based estimates of outcome after aortic valve replacement using a microsimulation model

Content Provider	IEEE Xplore Digital Library
Author	Takkenberg, J.J.M. Steyerberg, E.W. Puvimanasinghe, J.P.A. Eijkemans, M.J.C. van Herwerden, L.A. Habbema, J.D.F. Bogers, A.J.J.C.
Copyright Year	2001
Description	Author affiliation: Departments of Cardio-thoracic Surg. & Public Health, Erasmus Med. Center Rotterdam, Netherlands (Takkenberg, J.J.M.)
Abstract	Prognosis after aortic valve replacement (AVR) is determined by multiple interrelated factors. Standard statistical methods do not allow detailed insight into the factors that affect outcome in the individual patient The application of a microsimulation model to predict age- and gender-specific outcome is illustrated using reported estimates of the occurrence of valve-related events and outcomes after AVR with different aortic valve substitutes. Compared to healthy age-matched individuals, the life expectancy of patients after AVR is markedly reduced, especially in the younger age groups. This reduction is mainly due to excess mortality, while valve-related events play a minor role. Re-operation for structural valve deterioration is common in younger patients with tissue valves. Patients with mechanical valves have a high lifetime risk of suffering thrombo-embolic and bleeding events. The life expectancy of old patients is near-normal, illustrating a healthy-patient effect. Microsimulation allows detailed insight into the factors that affect survival after AVR. Microsimulation provides a useful and objective decision support tool.
Starting Page	141
Ending Page	144
File Size	349921
Page Count	4
File Format	PDF
ISBN	0780372662
ISSN	02766547
DOI	10.1109/CIC.2001.977611
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2001-09-23
Publisher Place	Netherlands
Access Restriction	Subscribed
Rights Holder	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Subject Keyword	Valves Virtual reality Cardiology Surgery Predictive models Prosthetics History Public healthcare Statistical analysis Hemorrhaging
Content Type	Text
Resource Type	Article

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