Mortality and complications in elderly patients undergoing cardiac surgery

Balsera, Emilio Curiel; Mora-Ordóñez, Juan M.; Castillo-Lorente, E.; Benitez-Parejo, Josele; Herruzo-Avilés, Ángel; Ravina-Sanz, Juan J.; Alvarez-Bueno, Miguel; Rivera-Fernández, Ricardo

doi:10.1016/j.jcrc.2012.12.011

Cited by 22 publications

(13 citation statements)

References 25 publications

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“…Higher age, female sex, low ejection fraction, diabetes, peripheral vascular disease, immunosuppression, renal failure, urgent or emergency surgery, a history of cardiac surgery, and the performance of prolonged bypass surgery, non-elective surgery, reoperation, and combined surgery have all been associated with mortality in cardiac surgery patients. [8][9][10]12,14,[18][19][20] . Postoperative factors related to mortality include sepsis, renal failure, myocardial infarction, stroke, and cardiac arrest, among other complications, and the utilization of intra-aortic balloon pump and prolonged mechanical ventilation.…”

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confidence: 99%

Prolonged Mechanical Ventilation as a Predictor of Mortality After Cardiac Surgery

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Prolonged Mechanical Ventilation as a Predictor of Mortality After Cardiac Surgery

et al. 2018

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“…Tamayo et al studied post-cardiac surgery patients and found a 90-day in-hospital mortality rate of 8.8% [9]. Curiel-Balsera et al performed a study using the ARIAM Andalus adult cardiac surgery registry, which included data from 11 hospitals in the autonomous region of Andalusia between 2008 and 2011, and reported intra-ICU mortality of 7.7% and 30-day mortality of 9.3% [10]. Rodríguez-Rieiro et al reported an observed mortality rate of 7.69% [11].…”

Section: Discussionmentioning

confidence: 99%

Sequential organ failure assessment score predicts mortality after coronary artery bypass grafting

et al. 2017

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BackgroundMortality after coronary artery bypass grafting (CABG) is generally associated with underlying disease and surgical factors overlooked in preoperative prognostic models. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE II) scores are widely used in intensive care units for outcome prediction. This study investigated the accuracy of these models in predicting mortality.MethodsBetween January 2010 and April 2013, 483 patients who underwent isolated CABG were enrolled. The clinical characteristics, outcomes, and prognostic model scores of the patients were collected. Discrimination was assessed using the area under the curve approach.ResultsBoth SOFA and APACHE II scores were effective for predicting in-hospital mortality. Among the organ systems examined in the SOFA, the cardiac and renal systems were the strongest predictors of CABG mortality. Multivariate analysis identified only the SOFA score as being an independent risk factor for mortality.ConclusionIn summary, the SOFA score can be used to accurately identify mortality after isolated CABG.

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“…Curiel-Balsera et al . performed a study with data obtained from The Registry of Adult Cardiac Surgery Platform ARIAMAndalusi, and which included data from 11 hospitals in the autonomous community of Andalusia between 2008 and 2011, in a prospective manner [23]. A total of 4,548 patients with cardiac surgery were included in the study, intra-ICU mortality was 7.7% and 30-day mortality was 9.3%.…”

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confidence: 99%

Development of the Post Cardiac Surgery (POCAS) prognostic score

et al. 2013

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IntroductionThe risk of mortality in cardiac surgery is generally evaluated using preoperative risk-scale models. However, intraoperative factors may change the risk factors of patients, and the organism functionality parameters determined upon ICU admittance could therefore be more relevant in deciding operative mortality. The goals of this study were to find associations between the general parameters of organism functionality upon ICU admission and the operative mortality following cardiac operations, to develop a Post Cardiac Surgery (POCAS) Scale to define operative risk categories and to validate an operative mortality risk score.MethodsWe conducted a prospective study, including 920 patients who had undergone cardiac surgery with cardiopulmonary bypass. Several parameters recorded on their ICU admission were explored, looking for a univariate and multivariate association with in-hospital mortality (90 days). In-hospital mortality was 9%. Four independent factors were included in the POCAS mortality risk model: mean arterial pressure, bicarbonate, lactate and the International Normalized Ratio (INR). The POCAS scale was compared with four other risk scores in the validation series.ResultsIn-hospital mortality (90 days) was 9%. Four independent factors were included in the POCAS mortality risk model: mean arterial pressure, bicarbonate ratio, lactate ratio and the INR. The POCAS scale was compared with four other risk scores in the validation series. Discriminatory power (accuracy) was defined with a receiver-operating characteristics (ROC) analysis. The best accuracy in predicting in-hospital mortality (90 days) was achieved by POCAS. The areas under the ROC curves of the different systems analyzed were 0.890 (POCAS), followed by 0.847 (Simplified Acute Physiology Score (SAP II)), 0.825 (Sepsis-related Organ Failure Assessment (SOFA)), 0.768 (Acute Physiology and Chronic Health Evaluation (APACHE II)), 0.754 (logistic EuroSCORE), 0.714 (standard EuroSCORE) and 0.699 (Age, Creatinine, Ejection Fraction (ACEF) score).ConclusionsOur new system to predict the operative mortality risk of patients undergoing cardiac surgery is better than others used for this purpose (SAP II, SOFA, APACHE II, logistic EuroSCORE, standard EuroSCORE, and ACEF score). Moreover, it is an easy-to-use tool since it only requires four risk factors for its calculation.

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Mortality and complications in elderly patients undergoing cardiac surgery

Cited by 22 publications

References 25 publications

Prolonged Mechanical Ventilation as a Predictor of Mortality After Cardiac Surgery

Prolonged Mechanical Ventilation as a Predictor of Mortality After Cardiac Surgery

Sequential organ failure assessment score predicts mortality after coronary artery bypass grafting

Development of the Post Cardiac Surgery (POCAS) prognostic score

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