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At least 253 records · Page 14Linked to original sources

PubMed2000

Visual neglect as a predictor of functional outcome one year after stroke.

OBJECTIVE: The aim was to study the role of visual neglect in acute right hemisphere brain infarct as a predictor of poor functional outcome during the first year after stroke. In particular, we were interested in the additional value of neglect measures besides hemiparesis, hemianopia, cognitive deficits and age. PATIENTS AND METHODS: A consecutive series of 57 patients with a neuroradiologically verified right hemisphere infarct was examined within 10 days of the stroke. Fifty patients were followed up for 1 year. Neglect was measured with the Conventional and the Behavioural subtests of the Behavioural Inattention Test (BITC and BITB, respectively). The predictors were determined at the 10-day examination. Functional outcome was assessed 3, 6 and 12 months after the onset with the Frenchay Activities Index. RESULTS: Neglect in BITB was the best single predictor, which together with high age formed the best combination of predictors for poor functional outcome at each follow-up. Hemiparesis was also included in this prediction model at the 3-month follow-up, but hemianopia, BITC, or visuoconstructional and memory deficits showed no additional predictive value. However, neglect usually recovered soon. When neurological and cognitive deficits were assessed at the same time as the outcome, hemiparesis rather than neglect was the strongest correlate of poor outcome. CONCLUSION: Neglect in acute stroke is an important predictor of poor functional recovery. Residual neglect, which could be compensated in the follow-up tests, may nevertheless restrict patients' real-life activities and hobbies.

Acute Disease↗

PubMed2001

Predictors of discharge to home during the first year after right hemisphere stroke.

OBJECTIVES: The aim of this study was to explore predictive factors of the length of hospital stay at the acute stage of right hemisphere stroke. Special attention was paid to the possible role of anosognosia for hemiparesis and anosognosia for neglect in this prediction. PATIENTS AND METHODS: A consecutive series of 57 patients having their first right hemisphere stroke were examined at the acute phase. Forty-nine patients were included in this study and followed-up for 12 months. The examinations were conducted within 2 weeks of onset. The outcome variable was the time (days) from stroke to discharge to home. The predictors were age, gender, size of infarct, neglect, hemiparesis, verbal memory, unawareness of illness, anosognosia for neglect, anosognosia for hemiparesis and presence of a relative at home. RESULTS: Hemiparesis and unawareness of illness lengthened the duration of the hospital stay, the presence of a relative reduced it. Neglect was the best single predictor of poor outcome, but it had no additional value in the combination of the three predictors above. Neither anosognosia for hemiparesis nor anosognosia for neglect were important predictors. CONCLUSION: Hemiparesis, unawareness of illness and presence of a relative at home were the best predictors of the time from right hemisphere stroke to discharge to home.

Activities of Daily Living↗

PubMed1986

Predictors of naturalistic sexual aggression.

This research integrated within a theoretical and empirical framework varied predictor factors pertaining to males' sexual aggression against women. The selection of predictors was guided by theorizing that sexual aggression is caused by the interaction among multiple factors, including those creating the motivation for the act, those reducing internal and external inhibitions, and those providing the opportunity for the act to occur. The predictor factors assessed were sexual arousal in response to aggression, dominance as a motive for sexual acts, hostility toward women, attitudes accepting of violence against women, psychoticism, and sexual experience. A measure assessing self-reported sexual aggression (primarily among acquaintances) in naturalistic settings served as the dependent measure. The subjects were 155 males. As expected, nearly all the predictor factors significantly related to sexual aggression. In addition, much better prediction of such aggression was achieved by a combination of these factors than by any one individually. It was also found that including interactions among these predictors yielded a regression equation that was more successful in relating to sexual aggression than an equation using an additive combination only. The relevance of these data to the causes and prediction of violence against women is discussed.

Adolescent↗

PubMed1996

Prospective predictors of quit attempts and smoking cessation in young adults.

This study examined prospective predictors of attempts to quit smoking and successful quitting among those who attempted to quit (n = 700), using a long-term longitudinal study of the natural history of cigarette smoking in a midwestern community sample. Participants, originally surveyed in 6th-12th grade (1980-1983), were followed up in 1987 and 1994. Results showed that amount of smoking, gender, education, health beliefs about smoking, value on healthy lifestyle, motives for smoking, reasons for quitting, and occupancy of young adult social roles were significant predictors of cessation. However, there were different predictors of attempts to quit and successful quitting among those who attempted to quit. From a public health perspective, both predictors of quit attempts and predictors of successful quitting among attempters are useful targets for intervention.

Adolescent↗

PubMed2005

The operational validity of a video-based situational judgment test for medical college admissions: illustrating the importance of matching predictor and criterion construct domains.

This study is part of a trend of examining noncognitive predictors, for example, a situational judgment test (SJT), as supplements to cognitive predictors for making college admission decisions. The authors examined criterion data over multiple academic years and universities. The criterion domain was broadly conceptualized, including both cognitive and interpersonal domains. The sample consisted of 7,197 candidates of the Medical and Dental Studies Admission Exam in Belgium. Results confirmed the importance of cognitive predictors. A video-based SJT was differentially valid for predicting overall grade point average for different curricula. The SJT showed incremental validity over cognitively oriented measures for curricula that included interpersonal courses, but not for other curricula. The SJT became more valid through the years. This demonstrates the importance of carefully specifying predictor- criterion linkages and of differentiating both predictor and criterion constructs.

Adolescent↗

PubMed2003

Perceived self-efficacy domains as predictors of fear of the unknown and fear of dying among older adults.

Using a sample of 167 women and 121 men, aged 65-87, this study tested the hypothesis that self-efficacy beliefs of older persons are significantly stronger predictors of death fears than are demographics, social support, and physical health variables used in earlier predictor models. Standard self-report measures were used to assess all predictor variables, including perceived self-efficacy in 8 different domains. Findings from a series of hierarchical regression analyses that were conducted separately for men and women supported the hypothesis concerning the superiority of self-efficacy variables as predictors of fear of the unknown after death and fear of dying, with spiritual health efficacy and instrumental efficacy being the most potent predictors of death fears for women and men, respectively.

Aged↗

PubMed2006

Patient characteristics as predictors of weight loss after an obesity treatment for children.

OBJECTIVE: To examine pretreatment patient characteristics as predictors of treatment outcome 2 years after completion of an inpatient treatment for children with obesity. RESEARCH METHODS AND PROCEDURES: Children (N = 122) ranging in age from 7 to 17 years [mean, 12.7 +/- 2.3 (SD) years] with a mean adjusted BMI of 179.5 +/- 28.6% participated in an inpatient obesity treatment program. Children (90.2% response rate) participated in the 2-year follow-up. Eight predictors, administered at baseline, were entered in separate regression analyses, with weight loss and changes on three psychological health measures as the outcome measures. RESULTS: Analyses revealed that baseline degree of overweight, age, and initial weight loss were significant positive predictors of weight loss 2 years after treatment, whereas eating disorder characteristics were a negative predictor. Sex, socioeconomic status, global self-esteem, and symptoms of psychopathology did not predict weight loss. With regard to the psychological outcome measures, baseline symptomatology emerged as the most important predictor of treatment changes. DISCUSSION: Long-lasting weight loss is associated with severity of pretreatment characteristics. Identification of the clinical markers for long-term response to treatment is useful to set realistic weight loss goals for clients and to tailor treatment programs to patient characteristics.

Adolescent↗

PubMed2001

Predictors of weight loss and maintenance during 2 years of treatment by sibutramine in obesity. Results from the European multi-centre STORM trial. Sibutramine Trial of Obesity Reduction and Maintenance.

BACKGROUND: In this report we assess pre-treatment determinants of weight loss and maintenance outcome in The Sibutramine Trial of Obesity Reduction and Maintenance (STORM), a 2 y randomized, double-blind, placebo-controlled, European multicenter study examining the effect of sibutramine (Sib) on inducing and maintaining weight loss in obese subjects. MATERIAL: A total of 605 obese patients (BMI: 30-45 kg/m2) of both gender were included from eight European centers and treated for 24 months. The patients were treated for the initial 6 months by Sib (10 mg/day) and a low-fat low-energy, individualized diet (600 kcal/day deficit). The 467 patients who achieved >5% weight loss after 6 months were randomized 3&ratio;1 to Sib (10 mg/day) (Sib/Sib) and placebo (Sib/Pla) for weight maintenance over a further 18 months. MAIN OUTCOME AND ANALYSES: Pre-treatment individual characteristics were assessed as predictors of 6 months weight loss (kg) and 24 months weight maintenance using simple and multivariate correlation and regression analyses. RESULTS: In univariate analyses, the 6 month weight loss (n=505) was positively associated with pre-treatment body weight (r=0.27), height (r=0.18), fat-free mass (r=0.21) (all P<0.001), fat mass (r=0.13, P<0.03), and resting metabolic rate (r=0.13, P<0.003). However, no relation was found with age, gender, smoking status, age at onset of obesity, or number of previous slimming attempts. The same predictors were found for weight change to endpoint in the Sib/Sib group (n=350), while no predictors were identified in the Sib/Pla (n=114). In the multivariate regression analysis only pre-treatment body weight predicted weight loss at 6 months (P<0.001). Weight change (kg) to 24 month was predicted by: 4.34+0.07*body weight (kg)-4*treatment (Sib=1, Pla=0)-0.06*age (y), (r2=8%, P<0.001). CONCLUSION: Only pre-treatment body weight seems to be an important independent predictor of 6 months weight loss and 24 month weight maintenance in this study on diet and Sib. As only 8% of the variation in 24 months weight change could be explained by the predictors, the clinical value of this information is limited.

Adolescent↗

PubMed1996

Pre-treatment characteristics, program philosophy and level of ancillary services as predictors of methadone maintenance treatment outcome.

Predictors of methadone maintenance treatment outcome have not been extensively studied as they relate to variations in program philosophy, nor have such predictors received much examination among recently treated, older cohorts of opioid addicts for whom drug use patterns have changed. Predictors of outcome were examined at 18 months post-treatment entry for 353 admissions to methadone maintenance who received random assignment to one of three counseling conditions: (1) medication only, (2) standard counseling and (3) enhanced services; and one of two contingency conditions: (1) no contingencies, and (2) contingency contracting in a six-cell 3 x 2 design. Subjects in contingency contracting conditions were placed on contingency contracts for positive urine toxicology results and ultimately discharged for unremitting drug use. All subjects completed the Addiction Severity Index (ASI) and provided weekly urine specimens. Predictors of urinalysis results and treatment retention were determined using bivariate and multivariate techniques. Interactions between subject characteristics by experimental condition assignment were also examined as predictors. Higher rates of total positive urine specimens were predicted by younger age, greater pre-treatment frequency of smoking cocaine, lower ASI psychiatric composite scores, and higher ASI legal composite scores. Higher rates of opiate positive specimens were predicted by younger age, lower pre-treatment frequency of alcohol intoxication, higher ASI legal and lower ASI employment and psychiatric composite scores, and assignment to medication only/no contingencies condition. Higher rates of cocaine positives were predicted by younger age, black race, lower ASI psychiatric composite score, greater pre-treatment frequency of intravenous and smoked cocaine use, less pre-treatment frequency of marijuana use, and lower methadone dose level. Assignment to enhanced/contingency contracting predicted lower rates of cocaine positives. Treatment retention was predicted by older age, non-black race, lower ASI legal composite score, higher methadone dose level and assignment to non-contingent conditions. While subject variables over which treatment providers have little control were, thus, related to outcome, type of treatment provided and methadone dose also influenced outcome.

Adolescent↗

PubMed2002

Predictors of nursing home placement and home nursing services utilization by elderly patients after hospital discharge in Taiwan.

BACKGROUND: Providing appropriate follow-up health/long-term care services after hospital discharge for elderly persons is important to enhance health and quality of life. Therefore, identifying factors that affect follow-up service utilization has become an important concern. Most studies of predictors of follow-up service utilization for elderly persons after discharge were conducted in the United States of America (USA). Taiwan differs substantially from the USA in health care system, clinical practice, case-mix, culture, and social organization; thus the findings from the USA need to be validated in Taiwan to ensure appropriate discharge referrals. AIM: To investigate pre-discharge predictors of follow-up care including home nursing services and nursing home placement for elderly patients, discharged from hospitals in Taiwan. METHODS: A prospective study with a case-control design was used. FINDINGS: The strongest predictors of institutionalization in a nursing home at 1, 3 and 6 months after discharge were the elderly person's pre-admission institutionalization (0.33 to 0.48) and the caregiver's preference for institutional displacement (0.23 to 0.85). The strongest predictors of use of home nursing services were the elder's self-care ability (0.69 to 0.76), conscious level (0.51 to 0.73), and tubes remaining before discharge (0.58 to 0.79). These predictors were stable at 1, 3 and 6 months after discharge and could correctly classify 60-89% of sample. CONCLUSIONS: When taking nursing home and home nursing utilization into considerations at the same time, the elderly person's pre-admission institutionalization and the caregiver's preference for institutional displacement strongly predicted nursing home utilization after hospital discharge. The elder's self-care ability, conscious level, and tubes remaining before discharge strongly predicted the use of home nursing services after discharge.

Aftercare↗

PubMed2002

Clinical predictors of defibrillation thresholds with an active pectoral pulse generator lead system.

Active pectoral pulse generators are used routinely for initial ICD placement because they reduce DFTs and simplify the implantation procedure. Despite the common use of these systems, little is known regarding the clinical predictors of defibrillation efficacy with active pulse generator lead configurations. Such predictors would be helpful to identify patients likely to require higher output devices or more complicated implantations. This was a prospective evaluation of DFT using a uniform testing protocol in 102 consecutive patients with an active pectoral can and dual coil transvenous lead. For each patient, the DFT was measured with a step-down protocol. In addition, 34 parameters were assessed including standard clinical echocardiographic and radiographic measures. Multivariate stepwise regression analysis was performed to identify independent predictors of the DFT. The mean DFT was 9.3 +/- 4.6 J and 93% (95/102) of patients had a DFT < or = 15 J. The QRS duration, interventricular septum thickness, left ventricular mass, and mass index were significant but weak (R < 0.3) univariate predictors of DFT. The left ventricular mass was the only independent predictor by multivariate analysis, but this parameter accounted for < 5% of the variability of DFT measured (adjusted R2 = 0.047, P = 0.017). The authors concluded that an acceptable DFT (< 15 J) is observed in > 90% of patients with this dual coil and active pectoral can lead system. Clinical factors are of limited use for predicting DFTs and identifying those patients who will have high thresholds.

Aged↗

PubMed1999

Predictors of health promotion lifestyle among three ethnic groups of elderly rural women in Taiwan.

The purpose of this study was to examine the predictors of health promotion lifestyle (HPL) and examine the similarities and differences among three ethnic groups of elderly rural women in Taiwan. Pender's Health Promotion Model was used as the conceptual framework of this study. A convenience sample of 599 elderly rural women was recruited from three rural areas: Kao-Shu, San-Di-Men, and Ma-Chia. Ho-Lo, Hakka, and aboriginal people are the three main ethnic groups in these areas. Of the 599 elderly women, 391 completed all of the interview questions. Subjects ranged from 65 to 91 years old. All instruments used in this study have been evaluated for their content validity. The interrater reliability and alpha coefficient reliability of all instruments were greater than 0.70. A survey-interview method was used to collect data. Findings showed that the predictors of HPL have differences and similarities among elderly rural women from different ethnicities. In the group of elderly Ho-Lo women, age, education, living arrangements, and perceived barriers to health promotion lifestyle (PBaHPL) were significant predictors and they explained 41.9% of total variance in HPL. In the group of elderly Hakka women, education, number of chronic health problems, PBaHPL, and perceived benefits of health promotion lifestyle (PBeHPL) were significant predictors in explaining 53.9% of total variance in HPL. Finally, in the group of elderly aboriginal women, living arrangements, PBaHPL, and PBeHPL were significant predictors in explaining 70.0% of total variance in HPL. Community nurses can use their understanding of different ethnic groups to assess, identify, and use effective health promotion interventions for elderly rural women.

Aged↗

PubMed2001

A comparison of acute and postdischarge predictors of employment 2 years after traumatic brain injury.

OBJECTIVE: To examine whether adding postdischarge psychosocial predictors to premorbid and injury-related variables improved the capacity to predict employment 2 years after rehabilitation for traumatic brain injury (TBI). DESIGN: Data were collected prospectively at 6 and 24 months after discharge from rehabilitation. Logistic regression analyses examined predictors of employment status. SETTING: Inpatient and community TBI rehabilitation service attached to a major Australian teaching hospital. PARTICIPANTS: Fifty-five patients with TBI, aged 16 or older, who were consecutively admitted to a brain injury unit with complete longitudinal data and who agreed to participate in the study. INTERVENTION: Measured injury severity (Glasgow Coma Scale scores, posttraumatic amnesia); functional independence (Functional Assessment Measure cognitive subscale) at admission and discharge from rehabilitation; self-report of employment (premorbid, postdischarge); postdischarge psychosocial status at 6 months and 2 years (Community Integration Questionnaire, General Health Questionnaire, Trauma Complaints List, Overt Aggression Scale, Alcohol Use Disorders Inventory Test, Satisfaction with Life Scale). MAIN OUTCOME MEASURES: Employment status (employed, unemployed) was used to reflect vocational outcome. Predictor variables comprised premorbid work status, injury-related variables (age, injury severity), and postdischarge variables (employment, community integration, psychologic, cognitive status). RESULTS: Adding postdischarge predictors to premorbid and acute variables significantly improved the ability to predict work status 2 years after rehabilitation. Age at the time of injury, premorbid employment status, work status, and psychologic distress 6 months postdischarge were significant predictors of employment. CONCLUSIONS: It is important to consider postdischarge psychologic well-being, in conjunction with premorbid and acute factors, in vocational interventions after TBI.

Adult↗

PubMed2004

Predictors of treatment response to behavioral therapy and pharmacotherapy for urinary incontinence.

Demographic, medical, and physiologic predictors of behavioral treatment and pharmacotherapy success would be useful in selecting treatments for specific patients with urinary incontinence based on their histories, physical examinations, and urodynamic profiles. The author performed a systematic review of clinical trials of behavioral treatment or pharmacotherapy for urinary incontinence. Most postulated predictors (age, type and duration of incontinence, medications including diuretics and estrogen, obstetric history, physical examination, and urodynamic findings) were not predictive of treatment outcomes. For behavioral therapy, male gender predicted worse outcomes in 1 study, but it was not a predictor in 2 other studies. Greater severity of incontinence predicted positive outcomes in 2 studies, negative outcomes in 3 studies, and had no predictive value in 5 studies. Prior treatment for incontinence predicted poorer outcomes in 2 studies of urge incontinence but was not predictive in a study of stress incontinence. Prior surgical treatment predicted better outcomes in 1 study of urge incontinence in women but was unrelated in 4 studies. Male gender, depression, or the use of assistive devices for ambulation predicted poorer outcomes in homebound older persons. For pharmacotherapy of urge incontinence, older age, female gender, and greater incontinence severity were associated with poorer outcomes in 1 study. Age was unassociated with outcomes in another study. Thus, the literature on predictors of outcomes of behavioral and drug treatment for urinary incontinence is inconsistent and does not provide guidelines for treatment selection. More studies, with large samples, that use multivariate regression analysis to examine predictors of outcomes are needed.

Behavior Therapy↗

PubMed2003

Predictors and consequences of food neophobia and pickiness in young girls.

OBJECTIVE: Vegetable intake among children is well below recommended levels. We assessed whether food neophobia and pickiness contribute to low vegetable intake in school-aged girls and if there are distinct predictors for neophobia and pickiness. Children with food neophobia are reluctant to eat new foods whereas picky children resist eating many familiar foods. Design/subjects Participants were 192 7-year-old girls and their parents, recruited for a study of girls' nutrition and development. We examined relationships between food neophobia and pickiness and assessed whether these variables predicted girls' vegetable consumption and predictors of food neophobia and pickiness. ANALYSES: The data were analyzed using a two-step process. First, we used a two-way analysis of variance to assess whether girls who scored high or low on food neophobia and pickiness measures had different levels of vegetable consumption. We used multiple regression analysis to determine predictors of food neophobia and pickiness in the girls. RESULTS: Girls with both food neophobia and pickiness consumed fewer vegetables (1.1+/-0.1) than girls with neither neophobia nor pickiness (1.6+/-0.1). Neophobia and pickiness were modestly related in this sample, but had different predictors. Girls with food neophobia were more anxious and had mothers with food neophobia. Picky girls had mothers with less variety in their vegetable intake (r=-0.22) and mothers who perceived their family to have little time to eat healthful foods (r=0.36). In addition, picky eaters were breastfed for fewer than 6 months (r=-0.25). Pickiness was predicted primarily by environmental or experiential factors subject to changes; neophobia was predicted by more enduring and dispositional factors. APPLICATIONS: Because food neophobia and pickiness negatively influence vegetable intake, intervention strategies to increase vegetable intake should focus on predictors of neophobia and pickiness, especially those subject to change.

Adult↗

PubMed2002

Risk stratification applied to CAST registry data: combining 9 predictors. Cardiac Arrhythmia Suppression Trial.

Over 200,000 people in the United States die of sudden cardiac death (SCD) every year. Although many of these deaths occur in asymptomatic individuals, the vast majority of deaths occur in people who are under care for existing coronary heart disease. Implantable cardioverter/defibrillators (ICDs) have been shown in several randomized trials to be effective in prolonging lives of those at high risk for sudden cardiac death, but the criteria used in these trials and the ACC/AHA consensus guidelines would cover only a minority of patients. Developing methods to assign risk to individual patients without prior SCD events could promote the use of this life-saving therapy in those with especially high risk. Given sufficient physiologically relevant measurements from electrocardiogram analysis, clinical assessment, and demographic status, multivariate statistical methods for predicting survival can be used to combine many predictors of risk and calculate the risk for an individual patient. A survival analysis using Cox regression on data from the Cardiac Arrhythmia Suppression Trial (CAST) illustrates this concept. Patient age, sex, ejection fraction, smoking history, and prior myocardial infarction history, along with the frequency of premature beats and the presence of runs of ventricular tachycardia on Holter monitoring and the time from the index myocardial infarction to the baseline Holter and to recruitment into CAST were combined in a multivariate predictor derived from the Cox regression; this predictor significantly outperforms the individual predictors. A proposed test based on this predictor would identify as positive 7% of the CAST registry, with an average risk of death among the positives of 47%; 20% of those dead at 2 years would be positive. With improved component measurements, this approach has the potential for significantly improving risk stratification for the prevention of SCD.

Age Factors↗

PubMed1998

Predictors of post-ERCP complications in patients with suspected choledocholithiasis.

BACKGROUND AND STUDY AIMS: Determinants of complications after endoscopic retrograde cholangiopancreatography (ERCP) have not yet been completely characterized. PATIENTS AND METHODS: Data were collected from an endoscopic database. Univariate analysis and multivariate logistic regression analysis were used to generate the best model of independent predictors of post-ERCP pancreatitis. RESULTS: The database included 1239 ERCP examinations carried out to investigate suspected choledocholithiasis over a five-year period. From these, 45 patients who developed post-ERCP complications were compared to a random sample of 486 patients who had undergone an uncomplicated ERCP for suspected choledocholithiasis. Univariate analysis demonstrated significant differences between the two patient groups for the following factors: age, using a cut-off point of 59 years (27% vs. 51%, P = 0.002), pancreatic channel opacification (73% vs. 58%, P = 0.05), and absence of common bile duct stones (41% vs. 24%, P = 0.03). Using multivariate logistic regression, the best model for predicting post-ERCP pancreatitis in patients undergoing sphincterotomy included age under 59 years (P = 0.04), and absence of a common bile duct stone (P = 0.004). The model yielded probabilities of developing post-sphincterotomy pancreatitis that ranged from 2.8% if no predictor was present, to 27% when both predictors were present. Among patients in whom a sphincterotomy was not performed, the only significant independent predictor found was pancreatic channel opacification (P = 0.05). CONCLUSION: Age under 59 years, pancreatic channel opacification, and an absence of common bile duct stones at ERCP are all independent predictors of post-ERCP pancreatitis.

Adolescent↗

PubMed1991

Predictors of event-free survival after balloon aortic valvuloplasty.

BACKGROUND: Balloon aortic valvuloplasty was developed as an alternative to aortic-valve replacement in selected elderly patients with aortic stenosis. The use of this procedure is limited, however, by a high incidence of restenosis. METHODS: Between December 1985 and April 1989, valvuloplasty was performed in 205 patients. We evaluated 40 demographic and hemodynamic variables as univariate predictors of event-free survival by Cox regression analysis and identified independent predictors of event-free survival by stepwise multivariate analysis. RESULTS: Early hemodynamic results indicated a decrease in the peak transaortic-valve pressure gradient from 67 +/- 28 to 33 +/- 15 mm Hg after valvuloplasty and an increase in aortic-valve area from 0.6 +/- 0.2 to 0.9 +/- 0.3 cm2 (P less than 0.001 for both comparisons). The rate of event-free survival (defined as survival without recurrent symptoms, repeated valvuloplasty, or aortic-valve replacement) was 18 percent over the mean (+/- SD) follow-up period of 24 +/- 12 months (range, 1 to 47). Significant predictors of event-free survival included the left ventricular ejection fraction and the left ventricular and aortic systolic pressure before valvuloplasty, and the percent reduction in the aortic-valve pressure gradient; the pulmonary-capillary wedge pressure was inversely associated with event-free survival. Although the predicted event-free survival rate for the entire patient group was 50 percent at one year (95 percent confidence interval, 43 to 57 percent) and 25 percent at two years (95 percent confidence interval, 19 to 31 percent), the probability of event-free survival at one year varied between 23 and 65 percent when patients were stratified according to three independent predictors: the aortic systolic pressure, the pulmonary-capillary wedge pressure, and the percent reduction in the peak aortic-valve gradient. CONCLUSIONS: The most important predictors of event-free survival after balloon aortic valvuloplasty were related to base-line left ventricular performance. The best long-term results after valvuloplasty were observed among patients who would also have been expected to have excellent long-term results after aortic-valve replacement.

Aortic Valve Stenosis↗