Stuart William Grant

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BACKGROUND Accurate risk-adjustment models are useful for clinical decision making and are important for minimizing any tendency toward risk-averse clinical practice. In cardiac surgery, emergency patients are potentially at greatest risk of inappropriate risk-averse clinical decisions. UK cardiac surgery outcomes are currently risk-adjusted with EuroSCORE(More)
OBJECTIVE The original EuroSCORE models are poorly calibrated for predicting mortality in contemporary cardiac surgery. EuroSCORE II has been proposed as a new risk model. The objective of this study was to assess the performance of EuroSCORE II in UK cardiac surgery. DESIGN A cross-sectional analysis of prospectively collected multi-centre clinical audit(More)
BRIEF SUMMARY Cardiac surgeons in the UK have openly published their outcome data at hospital and individual surgeon levels since 2005. Publication of these data has been associated with a decreased risk of inhospital mortality following cardiac surgery despite more high risk patients undergoing surgery. Cardiac surgeons in the UK have now developed a(More)
OBJECTIVES Progressive loss of calibration of the original EuroSCORE models has necessitated the introduction of the EuroSCORE II model. Poor model calibration has important implications for clinical decision-making and risk adjustment of governance analyses. The objective of this study was to explore the reasons for the calibration drift of the logistic(More)
Clinical registries will have an increasingly important role to play in health-care, with a number already established in cardiac surgery. This review covers the fundamentals of establishing and managing clinical registries, including legal and ethical frameworks along with intellectual property attribution. Also discussed are important issues relating to(More)
BACKGROUND The calibration of several cardiac clinical prediction models has deteriorated over time. We compare different model fitting approaches for in-hospital mortality after cardiac surgery that adjust for cross-sectional case mix in a heterogeneous patient population. METHODS AND RESULTS Data from >300 000 consecutive cardiac surgery procedures(More)
OBJECTIVE High-risk patients with aortic stenosis are increasingly referred to specialist multidisciplinary teams (MDTs) for consideration of trans-catheter aortic valve implantation (TAVI). A subgroup of these cases is unsuitable for TAVI, and high-risk conventional aortic valve replacement (AVR) is undertaken. We have studied our outcomes in this cohort.(More)
OBJECTIVES Biological valves are the most commonly implanted prostheses for aortic valve replacement (AVR) surgery in the UK. The aim of this study was to compare performance of porcine and bovine pericardial valves implanted in AVR surgery with respect to survival and reintervention-free survival in a retrospective observational study. METHODS(More)
BACKGROUND Abdominal aortic aneurysm (AAA) repair aims to prevent premature death from AAA rupture. Elective repair is currently recommended when AAA diameter reaches 5.5 cm (men) and 5.0 cm (women). Applying population-based indications may not be appropriate for individual patient decisions, as the optimal indication is likely to differ between patients(More)