Características clínico-demográficas de pacientes submetidos a cirurgia de revascularização do miocárdio e sua relação com a mortalidade

Oliveira, Eduardo Lafaiette de; Westphal, Glauco Adrieno; Mastroeni, Marco Fábio

doi:10.5935/1678-9741.20120009

Cited by 27 publications

(29 citation statements)

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“…As well, in another study in Santa Catarina/Brazil, the authors found the same relationship [15]. In our study, we found that age ≥ 65 years was not a predictor of mortality, similar to other reported by Ng et al [16] in a retrospective study with 1594 patients undergoing CABG alone, where no significant difference in hospital mortality between patients aged ≥ 70 years (5.4%) compared to those with less than 70 years (3.8%).…”

Section: Discussionsupporting

confidence: 67%

“…We found studies that described their groups of elderly with age ≥ 65 years-old [12], ≥ 70 yearsold [13][14][15][16][17], ≥ 75 years-old [6,21], ≥ 80 years-old [22] and ≥ 85 years-old [23]. Therefore we will suggest that more studies to be made in order to can to conclude in which age the risks factors of this surgery appear enlarged, whether preoperative, intraoperative or postoperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Impact of coronary artery bypass grafting in elderly patients

Aikawa¹,

Cintra²,

Leite³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Objective: To analyze the results of isolated on-pump coronary artery bypass graft surgery (CABG) in patients ≥ 65 years-old.Methods: Patients undergoing isolated on-pump CABG from December 1 st 2010 to July 31 th 2012 were divided in two groups: GE (elderly ≥ 65 years-old, n=103) and GA (adults < 65 years-old, n=150). Preoperative data, intraoperative (as cardiopulmonar bypass time, aortic clamping time, time length of stay in mechanical ventilation -MV -and number of grafts), and postoperative variable (as morbidity, mortality and time length of stay in hospital) were analyzed during hospitalization.Results: In GE, the morbidity rate was greater than in GA (30% vs. 14%, P=0.004), but there was no difference in the mortality rate (5.8% vs. 2.0%, P=0.165). In GA, there was higher prevalence DM (39.6% vs. 27%, P=0.043) and smoking (32.2% versus 19.8%, P=0.042); and in GE, higher prevalence of stroke (17% vs. 6.7%, P=0.013). There was no difference between the groups regarding intraoperative variables. After multivariate analysis, age ≥ 65-year-old was associated with greater morbidity, but it was not independent predictive factor for in-hospital mortality. Considering in-hospital mortality, stay in ward time length (P=0.006), cardiac (P=0.011) and respiratory complications (P=0.026) were independent predictive factors.Conclusion: This study suggests that patients ≥ 65-yearold were at increased risk of postoperative complications when submitted to isolated on-pump CABG in comparison to patients < 65-year-old, but not under increased risk of death.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Impact of coronary artery bypass grafting in elderly patients

Aikawa¹,

Cintra²,

Leite³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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“…O principal grupo de complicações pós-operatórias foi o de hemorragia ou baixo débito, que ocorreu em mais da metade dos casos, seguido pelos grupos de problemas cardiológicos não isquêmicos, isquêmicos, respiratórios, insuficiência renal aguda, afecções infecciosas e neurológicas, todos com percentuais acima de 10% (12) . A infecção superficial é definida como sendo aquela que ocorre até 30 dias após a realização da cirurgia, envolve somente pele ou tela subcutânea e, no mínimo, um dos seguintes aspectos, drenagem purulenta com ou sem confirmação laboratorial; organismos isolados de cultura colhida de forma asséptica da secreção ou tecido superficial; sinais flogísticos ou incisão superficial aberta pelo cirurgião (13) .…”

Section: Methodsunclassified

“…As alterações pulmonares surgem a partir de inúmeros fatores, principalmente em virtude do uso de circulação extracorpórea, que ocasiona discretas alterações metabólicas e eletrolíticas no paciente, deixando-o mais suscetível às infecções (1) . Observou-se maior prevalência de disfunção renal, com evolução para IRA em torno de 7% a 30% (5,(13)(14) .…”

Section: Methodsunclassified

Complicações Pós-Operatórias Em Pacientes Submetidos À Cirurgia Cardíaca Em Hospital De Ensino

Beccária¹,

Cesarino²,

Werneck³

et al. 2015

ACS

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ResumoIntrodução: A taxa de mortalidade hospitalar é indicador de resultados para avaliação da qualidade da assistência em unidade coronária. Objetivos: Caracterizar os pacientes submetidos à cirurgia cardíaca, identificar os tipos de cirurgia e as principais complicações nos primeiros 30 dias pós-cirurgia. Material e Métodos: Estudo retrospectivo, longitudinal, quantitativo envolvendo pacientes submetidos a cirurgia cardíaca em um hospital de ensino, de janeiro de 2003 a abril de 2012. Resultados: Foram avaliados 2.648 pacientes, 61% do sexo masculino e 39% do feminino, com idade entre 49 a 66 anos, com média de Índice de Massa Corpórea de 26. As doenças de base mais comuns foram Diabetes Mellitus e Doença Renal Crônica. Realizaram revascularização do miocárdio 1.641 pacientes (62%) e cirurgia valvar 1.007 (38%). As principais complicações pós-operatórias foram lesão renal aguda até 7º dia pós-operatório (32%), disfunção de ventrículo esquerdo moderada/grave (20%), reintubação por complicações pulmonares (11%), fibrilação atrial (8,6%) e lesão neurológica (4,3%). O tempo médio de permanência na Unidade Coronária foi de 6,8 dias e a maioria necessitou de circulação extracorpórea. Dos 22% de pacientes com história pregressa de diabetes, 25% morreram. Conclusões: A maioria submeteu-se à revascularização do miocárdio; 65% desenvolveram lesão renal aguda e 44% foram reintubados por complicações pulmonares e associação significativa com óbito. Dos 190 pacientes que morreram nos primeiros 30 dias, as complicações de maior prevalência foram afecções cardíacas, infecção hospitalar, distúrbio de coagulação, complicações neurológicas e pulmonares. Descritores:Complicações; Óbito; Pós-operatório; Cirurgia Cardíaca. Abstract Introduction: Hospital mortality rate is an indicator of outcomes to evaluate the quality of health care in a coronary care unit. Objectives: The aims of the present study are to characterize patients undergoing cardiac surgery, as well as to identify the types of surgery and its main complications in the first 30 postoperative days. Material and Methods: We carried out a retrospective longitudinal study using a quantitative approach involving patients who underwent cardiac surgery at a teaching hospital from January 2003 to April 2012. Results: We evaluated 2,648 patients, 61% males, and 39% females, with a mean age ranging from 49 to 66 years. Patients mean Body Mean Index was 26. The most common underlying diseases were diabetes mellitus and chronic renal insufficiency. We performed Coronary Artery Bypass Grafting in 1,641 patients (62%) and heart valve surgery in 1,007 (38%). The main postoperative complications were acute kidney injury on the 7 th postoperative day 7 (32%), moderate to severe left ventricular dysfunction (20%), reintubation due to pulmonary complications (11%), atrial fibrillation (8.6%), and neurological lesions (4.3%). The mean length of stay in Coronary Care Unit was 6.8 days. The majority of the patients required cardiopulmonary bypass. Of the 22% of patients with a prior histo...

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“…The literature reveals higher rates of morbidity and mortality in women than in men undergoing CABG (22) .…”

mentioning

confidence: 99%

Overweight And Obesity Repercussion In The Postoperative Of Myocardial Revascularization Surgery

Araujo

Araújo

Bezerra

2014

Rev. esc. enferm. USP

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RESUMENEstudio descriptivo, transversal y retrospectivo de abordaje cuantitativo, cuyo objetivo fue relacionar el Índice de Masa Corporal (IMC) a los eventos ocurridos en el postoperatorio de la cirugía de revascularización miocárdica. La recolección de datos se realizó entre abril y junio del 2012. Los participantes fueron divididos según su IMC en tres grupos: aquellos con estado nutricional normal, con sobrepeso y obesos. El análisis de datos se basó en la estadística descriptiva. Se encontró que los participantes eutróficos tuvieron más complicaciones, especialmente pulmonares. Ente los individuos con sobrepeso y obesidad destacaron las complicaciones cardiovasculares, teniendo los sujetos con obesidad peor pronóstico. Se concluyó que no existe asociación estadísticamente significativa entre la obesidad y el sobrepeso con la mayor frecuencia de complicaciones postoperatorias a pesar de la ocurrencia de complicaciones cardiovasculares en esos grupos. El conocimiento de esas posibles complicaciones posibilita la planificación adecuada de los cuidados de enfermería a partir de la práctica basada en la evidencia. DESCRIPTORES ABSTRACTThis is a descriptive, retrospective study with cross-sectional quantitative approach, which aimed to relate the body mass index with events in the postoperative period of the myocardial revascularization surgery with use of extracorporeal circulation. The data collection period was between April and June/2012. Patients were divided according to the body mass index and classified as without excess of weight, overweight or obese. The data analysis was based on the descriptive statistics. The patients without excess of weight had more complications, especially those related to the lungs. Among overweight and obese individuals, the cardiovascular complications stood out. The obese subjects had the worse prognostic. Obesity and overweight did not have statistically significant association with a higher frequency of postoperative complications, in spite of the occurrence of cardiovascular complications in this group. The patients without excess of weight had higher risks of developing neurological events.

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Características clínico-demográficas de pacientes submetidos a cirurgia de revascularização do miocárdio e sua relação com a mortalidade

Cited by 27 publications

References 27 publications

Impact of coronary artery bypass grafting in elderly patients

Impact of coronary artery bypass grafting in elderly patients

Complicações Pós-Operatórias Em Pacientes Submetidos À Cirurgia Cardíaca Em Hospital De Ensino

Overweight And Obesity Repercussion In The Postoperative Of Myocardial Revascularization Surgery

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