The Use Of Catecholaminergic Inotropic Agents is Not An Independent Risk Factor For 30-Day Mortality

Abstract

Objective: Low cardiac output syndrome can develop in patients who have undergone open heart surgery. Inotropic drug therapy is being initiated to improve cardiac performance, but these drugs also have significant side effects. The primary aim of this study is to determine the relationship between the use of inotropic drugs and 30-day mortality, however its secondary aim is to determine the independent factors predicting mortality. Material and Method: Our retrospective observational study included 1002 patients undergoing cardiac surgery with cardiopulmonary bypass. Demographic and intraoperative characteristics of patients, use of inotropic agents, postoperative 30-day mortality data were obtained from anesthesia records, postoperative intensive care records and epicrises. Results: Dopamine (n=274: 27.3%), dobutamine (n= 110: 11%) and adrenaline (n=63: 6.3%) were used in indicated number of patients. In the univariate analysis, inotropic drug use was associated with mortality, but multiple regression analysis showed that inotropic drug use was not an independent risk factor for mortality alone. Independent risk factors for mortality were found to be advanced age, hypertension, heart failure, low ejection fraction and preoperative anemia. Conclusion: Our findings showed that inotropic use in perioperative period was not an independent predictor of 30day-mortality. Although this result is not compatible with studies performed with small number of samples, it is correlated with large-scale patient studies. Independent risk factors for 30-day-mortality were advanced age, hypertension, heart failure, low ejection fraction, and peroperative hemoglobin drop. Our findings are compatible with frequently seen risk factors in research. More progress is needed in this regard.