Relevant bibliographies by topics / Cardiac surgery mortality

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers

Academic literature on the topic 'Cardiac surgery mortality'

Author: Grafiati
Published: 4 June 2021
Last updated: 16 February 2022

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Journal articles on the topic "Cardiac surgery mortality"

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Geraci, Jane M., Michael L. Johnson, Howard S. Gordon, Nancy J. Petersen, A. Laurie Shroyer, Frederick L. Grover, and Nelda P. Wray. "Mortality After Cardiac Bypass Surgery." Medical Care 43, no. 2 (February 2005): 149–58. http://dx.doi.org/10.1097/00005650-200502000-00008.

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Treasure, Tom. "Mortality in adult cardiac surgery." BMJ 330, no. 7490 (March 3, 2005): 489–90. http://dx.doi.org/10.1136/bmj.330.7490.489.

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Alario, Jorge Martinez, Ignacio Diaz de Tuesta, Eliseo Plasencia, Meliton Santana, and Maria Luisa Mora. "MORTALITY PREDICTION IN CARDIAC SURGERY PATIENTS." Critical Care Medicine 27, Supplement (January 1999): 98A. http://dx.doi.org/10.1097/00003246-199901001-00248.

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Martínez-Alario, J., I. D. Tuesta, E. Plasencia, M. Santana, and M. L. Mora. "Mortality Prediction in Cardiac Surgery Patients." Circulation 99, no. 18 (May 11, 1999): 2378–82. http://dx.doi.org/10.1161/01.cir.99.18.2378.

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Chowdhury, Ujjwal. "Tracheostomy in Infants after Cardiac Surgery: Indications, Timing and Outcomes." Clinical Cardiology and Cardiovascular Interventions 4, no. 10 (May 24, 2021): 01–16. http://dx.doi.org/10.31579/2641-0419/164.

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Objective: There is little consensus on the indications and optimal timing of tracheostomy in the pediatric population. Our primary aim was to determine if early tracheostomy improves patient outcomes (between 10th and 15th postoperative day). Methods: A retrospective review of 84 neonates and infants requiring tracheostomy after cardiac surgery between January 1997 and December 2019 was performed. Indications and timings for tracheostomy, and risk factors for mortality were analyzed using Cox regression analysis. The receiver operating characteristic curve analysis, Youden’s index, sensitivity and specificity plot were performed to determine the optimal cut-off point of the timing of tracheostomy. Results: Twenty-five (29.76%) neonates and 59 (70.23%) infants with a median weight 7.6 kg (IQR: 3.1-9.25 kg) were studied. Extubation failure and unsuccessful weaning from ventilator occurred in 45 (53.6%) and 39 (46.4%) patients respectively. The timing of tracheostomy of 15 days as the optimal cut-off point was associated with a sensitivity of 73% and a specificity of 84% and a Youden’s index of 0.60. Early tracheostomy was associated with decreased mortality (p<0.001), morbidity (p<0.001), decreased duration of ventilation (p<0.001), ICU length of stay (p<0.001) and decreased time of decannulation (p<0.001). The hazard of death was 5.26 times (95% CI: 1.47-20.36) higher in patients undergoing late tracheostomy. At a median follow-up of 166 (IQR: 82.5-216) months, the actuarial survival was 86.61%±0.04%. Conclusions: Early tracheostomy within 15th postoperative day was associated with lower perioperative and late mortality, morbidity and ICU stay compared with tracheostomy between 15-30 days, and confers significant long-term advantages.
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Swinkels, B. M., and H. W. Plokker. "Evaluating operative mortality of cardiac surgery: first define operative mortality." Netherlands Heart Journal 18, no. 7 (July 2010): 344–45. http://dx.doi.org/10.1007/bf03091788.

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Ivanov, Joan, and Richard D. Weisel. "Adult cardiac surgery mortality and morbidity program." Journal of the American College of Cardiology 15, no. 2 (February 1990): A271. http://dx.doi.org/10.1016/0735-1097(90)92798-7.

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Ballenger, J. C. "Depression Predicts Mortality Following Cardiac Valve Surgery." Yearbook of Psychiatry and Applied Mental Health 2006 (January 2006): 257–58. http://dx.doi.org/10.1016/s0084-3970(08)70251-2.

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Bignami, Elena, Giuseppe Biondi-Zoccai, Giovanni Landoni, Oliviero Fochi, Valentina Testa, Imad Sheiban, Francesco Giunta, and Alberto Zangrillo. "Volatile Anesthetics Reduce Mortality in Cardiac Surgery." Journal of Cardiothoracic and Vascular Anesthesia 23, no. 5 (October 2009): 594–99. http://dx.doi.org/10.1053/j.jvca.2009.01.022.

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QUINN, KARL P. "Mortality of Gastrointestinal Complication After Cardiac Surgery." Archives of Surgery 122, no. 8 (August 1, 1987): 957. http://dx.doi.org/10.1001/archsurg.1987.01400200107022.

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Dissertations / Theses on the topic "Cardiac surgery mortality"

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Marsch, Stephan Christoph Ulrich. "Effects and interactions of anaesthesia and myocardiac ischaemia on left ventricular diastolic function." Thesis, University of Oxford, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259937.

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Reed, Grant William. "Associations Between Cardiac Troponin, Mechanism of Myocardial Injury, and Long-Term Mortality After Non-Cardiac Vascular Surgery." Case Western Reserve University School of Graduate Studies / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=case1491571890479287.

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Hedberg, Magnus. "Stroke during cardiac surgery : risk factors, mechanisms and survival effects." Doctoral thesis, Umeå universitet, Kirurgi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-38079.

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Introduction: Neurological complications and stroke in association with cardiac surgery is a serious problem. The stroke event can occur during surgery (early stroke) or in the postoperative period with a symptom free interval (delayed stroke). Particle embolization due to aortic manipulation during surgery has been suspected as a mechanism for early stroke. The present thesis address mechanisms and survival effects of stroke both clinically (I-III) and experimentally (IV-V). Methods: Study I) Within a cohort of 2641 consecutive cases, a group of cardiac surgery patients with stroke and evaluated by computed tomography (CT) were studied (n=77). CT-findings were analyzed in relation to stroke symptoms. Study II) Data from 9122 patients undergoing coronary surgery were analyzed. Records of patients with any signs of neurological complications were reviewed to extract 149 subjects with stroke at extubation (early, 1.6%) versus 99 patients having a free interval (delayed, 1.1%). Early and delayed stroke were evaluated separately. Independent risk factors for stroke were analyzed by logistic regression and survival by Cox regression (9.3 years median follow-up). Study III) Patients with early (n=223) and delayed stroke (n=116) were identified among 10809 patients undergoing cardiac and aortic surgery, both groups exposed to cardiopulmonary bypass. Stroke patients were subdivided by the hemispheric location of lesions. Subgroups were compared and their associated pre- and peroperative variables and survival were analyzed. Study IV) Aortic cross-clamp manipulation was studied in a human cadaveric perfusion model. The pressurized aorta was repeatedly cross-clamped and washout samples were collected before and after clamp maneuvers. Particles in the washout samples were evaluated by microscopy and by digital image analysis. Study V) Pig aortas were pressurized and cannulated. Washout samples were collected before and after cannulation (n = 40). Particles were deposited onto a 10-μm filter to be evaluated by microscopy and digital image analysis. Results: Study I) In the group of patients exposed to routine cardiac surgery (i.e., clamping and cannulation) and with early stroke, right-hemispheric lesions were more frequent than of the contra-lateral side (P=0.005). Patients with aortic dissections had a strong dominance of bilateral findings, which was different from the unilateral pattern in the routine-surgery group (P<0.001). Study II) Early and delayed stroke did not share any risk factors. Both early and delayed stroke explained mortality in the early postoperative period (P<0.001, P<0.001 respectively) but also at long term follow-up (P=0.008, P<0.001 respectively). For patients surviving their first postoperative year, delayed but not early stroke influenced long-term mortality (P=0.001 and P=0.695, respectively). Study III) Stroke lesions in association to cardiac surgery were near exclusively ischemic. Early stroke had a preponderance for right-hemispheric lesions (P=0.009). In contrast, patients with early stroke that had undergone surgery of the aorta with circulatory arrest showed a pattern with more bilateral lesions compared to ‘cardiac-type’ operations (P<0.001). Patients with bilateral lesions had a dramatically impaired survival compared to those with unilateral lesions (P<0.001). Study IV) In the cadaveric perfusion model, cross-clamping produced a significant output of particles, which was seen for size intervals of 1 mm and smaller (P=0.002 to P=0.022). In all size intervals the particle output correlated with the degree of overall aortic calcification (P =0.002 to P=0.025). Study V) At cannulation of the pig aorta, more particles were noted after cannulation compared to before the maneuver (P<0.001). This increase included small (<0.1 mm, P<0.001) and intermediate-size particles (0.1-0.5 mm, P< 0.001). Particles above 0.5 mm were few and were not associated with cannulation. Conclusions: The influence of stroke on mortality was devastating, for both early and delayed stroke. These two stroke groups had obvious differences in both their risk factors and their hemispheric distribution. It is here emphasized that early and delayed stroke should be considered as two separate entities with suggested mechanistic differences. Ischemic lesions accounted for near all stroke events seen in association to cardiac surgery. For early stroke, these were mostly located within the right hemisphere. Results from the experimental studies underscore microembolic risks associated with aortic manipulation.
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Clarke, Sean Patrick. "Psychosocial correlates of mortality, cardiac events, health care utilization, and quality of life in patients with left ventricular dysfunction." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0002/NQ44386.pdf.

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Nina, Rachel Vilela de Abreu Haickel. "EVOLUÇÃO PÓS-OPERATÓRIA IMEDIATA DE PORTADORES DE CARDIOPATIAS CONGÊNITAS SUBMETIDOS À CIRURGIA CARDÍACA NO HU-UFMA." Universidade Federal do Maranhão, 2007. http://tedebc.ufma.br:8080/jspui/handle/tede/1188.

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Made available in DSpace on 2016-08-19T18:16:08Z (GMT). No. of bitstreams: 1 Rachel Vilela de Abreu Heckel.pdf: 289635 bytes, checksum: 3a1271ac479a4c44330fb0b300d6c9ac (MD5) Previous issue date: 2007-02-01
Congenital heart disease are a group of rare defects highly associated with mortality in infancy. In the past 25 years great improvements on the care of this patients had lead us to an augmentation in the number of surgeries but still persists differences among all centers that perform surgery for congenital heart defects. The aim of this study was identify risk factors associated with poor outcomes after cardiac surgery in a population under 18 year old at the Cardiac Surgery Unit of The University Hospital of The Federal University of Maranhao. The period of the study was from June 2001 through June 2004. There were 145 patients,of which 62% were female, with median age of 5,1 years old, 56% came from the capital of the state and 11% had another associated congenital abnormality. The RACHS-1 classification(Risk adjustment for Congenital Heart Surgery) was applied to classify the adjusted risk for each surgical procedures. The risk factors identified were age, type of cardiopathy, pulmonary blood flow, cardiopulmonary bypass-time and aortic clamp time. The RACHS-1 score was applied to all 145 patients, and demonstrated increased risk of mortality for those patients in the higher score groups, although the rate found in this study was higher than that estimated by the RACHS-1 .
As cardiopatias congênitas são defeitos raros, cuja combinação é uma causa importante de óbito na infância. Os avanços ocorridos nos últimos 25 anos permitiram a ampliação do atendimento à população pediátrica portadora destes defeitos, no entanto ainda persistem diferenças entre os mais variados serviços. Com o objetivo de conhecer, descrever e avaliar a evolução pós-operatória dos pacientes pediátricos submetidos a tratamento cirúrgico realizou-se analítico, transversal, retrospectivo, no Hospital Universitário da Universidade Federal do Maranhão (HU-UFMA), no período 18 de junho de 2001 a 30 de junho de 2004. Cento e quarenta e cinco pacientes foram identificados, 62% eram do sexo feminino, 45,5% tinham entre um e cinco anos de idade à época da cirurgia (média de 5,1 anos) e 56,5% eram procedentes da capital do Estado, outras malformações associadas estiveram associadas em 11% dos pacientes, sendo a Síndrome de Down a anormalidade cromossômica mais comum. Utilizou-se o escore de risco de ajustado para cirurgia cardíaca de cardiopatias congênitas(RACHS:-1), o qual classifica os procedimentos cirúrgicos em categorias de risco de 1 a 6, e estima a mortalidade por categorias. Os fatores de risco inicialmente identificados foram a idade, o tipo de cardiopatia, o fluxo pulmonar, o tipo de cirurgia, o tempo de CEC e o tempo de anóxia. Concluiu-se que a idade entre cinco e dez anos, o hipofluxo pulmonar, o tempo de CEC acima de 65 minutos e o tempo de anóxia maior que 35,5 minutos foram fatores de risco significantes para mortalidade nesta população;a cardiopatia acianogênica mostrou significância apenas no tratamento estatístico inicial (teste do qui-quadrado), não se confirmando na análise de regressão logística; e a compatibilização as categorias de risco mais elevado e o progressivo aumento de taxa de mortalidade, porém em percentuais mais elevados para o grupo em estudo.
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Hajjar, Ludhmila Abrahão. "Estudo prospectivo e randomizado das estratégias liberal e restritiva de transfusão de hemácias em cirurgia cardíaca." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5152/tde-31082010-164814/.

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Introdução: O objetivo deste estudo foi avaliar o efeito de uma estratégia restritiva de transfusão de hemácias comparada a uma estratégia liberal na evolução clínica de pacientes submetidos à cirurgia cardíaca com circulação extracorpórea. Métodos: Estudo prospectivo, randomizado, e controlado. Foram randomizados 512 pacientes para uma estratégia liberal de transfusão (hematócrito 30%) ou restritiva (hematócrito 24%). Resultados: Os pacientes apresentaram idade média de 60,7 ± 12,5 anos no grupo liberal e 58,6 ± 12,5 anos no grupo restritivo. Em ambos, houve predomínio de pacientes com fração de ejeção normal, mas 13% dos pacientes do grupo liberal e 15% do grupo restritivo apresentavam fração de ejeção abaixo de 40%. A mortalidade ou a morbidade grave em 30 dias foi semelhante nos dois grupos (10% na estratégia liberal e 11% na estratégia restritiva, P=0,518). Não houve diferença entre os grupos em relação às taxas de complicações secundárias. A média da concentração de hemoglobina foi 10,5 0,9 g/dL no grupo liberal e 9,1 1,2 gdL no grupo restritivo (P<0,001). No grupo liberal, 198 pacientes (78%) receberam transfusão de hemácias, e no grupo restritivo 118 pacientes (47%). Independente da estratégia utilizada, o número de transfusão de hemácias foi fator preditor independente para a ocorrência de complicações clínicas graves ou morte em 30 dias (OR=1,21; IC 95%=1,1-1,4, P= 0,002). Conclusão: A estratégia restritiva de transfusão foi tão segura quanto à estratégia liberal em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea. Cada unidade de concentrado de hemácias administrada foi associada a aumento de 1,2 vezes no risco de mortalidade em 30 dias
Introduction: The aim of this study was to evaluate whether a restrictive strategy of red blood cells transfusion is as safe as a liberal one with respect to clinical outcomes. Methods: In this prospective, randomized, controlled clinical trial we randomly assigned 512 patients after cardiac surgery to a liberal strategy of transfusion (to maintain a hematocrit at least at 30%) or to a restrictive one (to maintain a hematocrit at least at 24%). Results: The mean age of patients was 60.7 ± 12.5 year-old in liberal group vs. 58.6 ± 12.5 year-old in restrictive group. In both groups, most patients had normal left ventricular function, but 13% of patients in the liberal group and 15% in the restrictive one presented ejection fraction of less than 40%. The primary end-point - a composite endpoint of 30 day all cause mortality or severe morbidity was similar between groups (10% in the liberal-strategy group vs. 11% in the restrictive-strategy group) (P=0.518). Also, there were no differences between groups with respect to the rates of other complications. Hemoglobin concentrations were maintained at a level of 10.5 ± 0.9 g/dL in the liberal group and 9.1 ± 1.2 g/dL in the restrictive group (P<0.001). A total of 198 patients (78%) in the liberal group and 118 patients (47%) in the restrictive group received a blood transfusion (P<0.001). Independently of the strategy group, the number of transfused RBC units was an independent risk factor for the occurrence of several clinical complications or death at 30 days (HR = 1.21; CI 95%=1.1-1.4, P=0.002). Conclusions: A restrictive transfusion strategy was as safe as a liberal strategy in patients undergoing cardiac surgery. For each RBC unit transfused, transfusion was independently associated with a 1.2-fold higher risk of death at 30 days
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Issa, Mario. "Variáveis prognósticas de evolução hospitalar e no longo prazo de pacientes portadores de dissecção crônica de aorta tipo A de Stanford e aneurisma de aorta ascendente, submetidos a procedimento cirúrgico." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/98/98131/tde-28062012-103725/.

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Introdução: Aneurismas e dissecções da aorta constituem as principais doenças da aorta, as quais podem ser submetidas a princípios e técnicas de tratamento cirúrgico em comum. A conduta clínica e cirúrgica continua sendo um desafio nos procedimentos eletivos, bem como em casos de emergência. Informações sobre variáveis prognósticas associadas independentemente com óbito hospitalar e no longo prazo, são escassas, havendo necessidade da identificação destes fatores para a avaliação apropriada sobre o risco cirúrgico desta população. Objetivos: Primário: identificar variáveis prognósticas associadas independentes ao óbito hospitalar em pacientes submetidos a procedimento cirúrgico para correção de doenças da aorta. Secundários: identificar variáveis prognósticas associadas independentes ao óbito tardio e ao desfecho clínico composto (óbito, sangramento, disfunção ventricular e complicações neurológicas). Casuística e Métodos: Delineamento transversal com componente longitudinal, com coleta de dados retrospectiva e prospectiva. Pacientes consecutivos, portadores de aneurisma de aorta ascendente ou dissecção crônica de aorta tipo A de Stanford, foram incluídos por meio de revisão de prontuários. Foram incluídos 257 pacientes, cujos critérios de inclusão envolviam aqueles que foram operados por dissecção crônica de aorta tipo A de Stanford e aneurisma de aorta ascendente. Foram excluídos pacientes com dissecção aguda de aorta, de qualquer tipo, e pacientes que tiveram aneurisma de aorta em outro segmento da aorta que não fosse a aorta ascendente. Os desfechos clínicos avaliados foram óbito, sangramento clinicamente relevante, complicações neurológicas e disfunção ventricular, fase hospitalar e óbito no longo prazo. As variáveis prognósticas avaliadas incluíram: demografia, fatores pré-operatórios, fatores intra-operatórios e complicações pós-operatórias. O seguimento médio foi de 970 dias. O tamanho de amostra foi definido por conveniência aliado a publicações prévias sobre o tópico. Análise univariada foi realizada para selecionar variáveis para serem inseridas no modelo multivariado para identificação das variáveis prognósticas independentemente associados aos desfechos clinicamente relevantes. Resultados: As seguintes variáveis prognósticas apresentaram associação independente como o risco aumentado de óbito na fase hospitalar (RC; IC95%; P valor): etnia negra (6.8; 1.54-30.2; 0,04), doença cerebrovascular (10.5; 1.12-98.7; 0,04), hemopericárdio (35.1; 3.73-330.2; 0,002), cirurgia de Cabrol (9.9; 1.47-66.36; 0,019), cirurgia de revascularização miocárdica (4.4; 1.31-15.06; 0,017), revisão de hemostasia (5.72 ;1.29-25.29; 0,021) e circulação extra-corpórea [min] (1.016; 1.007-1.026; 0,001). A presença de dor torácia associou-se independentemente com o risco reduzido de óbito hospitalar (0.27; 0.08-0.94; 0,04). As seguintes variáveis apresentaram associação independente com o risco aumentado do desfecho clínico composto na fase hospitalar: uso de antifibrinolítico (3.2; 1.65-6.27; 0,0006), complicação renal (7.4; 1.52-36.0; 0,013), complicação pulmonar (3.7; 1.5-8.8; 0,004), EuroScore (1.23; 1.08-1,41; 0,003) e tempo de CEC [min] (1.01; 1.00-1.02; 0,027). As seguintes variáveis apresentaram associação independente com o risco aumentado de óbito no longo prazo: doença arterial obstrutiva periférica (7.5; 1.47-37.85; 0,015), acidente vascular cerebral prévio (7.0; 1.46-33.90; 0,015), uso de estatina na alta hospitalar (4.9; 1.17-21.24; 0,029) e sangramento aumentado nas primeiras 24 horas (1.0017; 1.0003-1.0032; 0,021). Conclusão: Etnia negra, doença cerebrovascular, hemopericárcio, cirurgia de Cabrol, revascularização miocárdica cirúrgica associada, revisão de hemostasia e tempo de CEC associaram-se independentemente com risco aumentado de óbito hospitalar. A presença de dor torácica associou-se independentemente com o risco reduzido de óbito hospitalar. Doença arterial obstrutiva periférica prévia, acidente vascular cerebral prévio, uso de estatina na alta hospitalar e sangramento aumentado nas primeiras 24 horas associaram-se independentemente com risco aumentado de óbito no prazo longo. Uso de antifibrinolítico, complicação renal, complicação pulmonar, EuroScore e tempo de CEC associaram-se independentemente com o risco aumentado de desfecho clínico composto hospitalar (óbito, sangramento, disfunção ventricular e complicações neurológicas).
Introduction: Both aortic aneurisms and dissections constitute the main aortic diseases, sharing common principles and surgical procedure approaches. Medical and surgical management are seen as a medical challenge concerning elective procedures as well as in emergency cases. Data on prognostic variables independently associated with both hospital and long term death are scarce, leading to a need for appropriate identification of those factors for proper surgical risk evaluation of this population. Objectives: Primary: to identify prognostic variables independently associated with hospital death in patients who underwent surgical procedures for aortic disease correction. Secondary: to identify prognostic variables independently associated with long term death and with composite clinical endpoint (death, bleeding, ventricular dysfunction and neurological complications). Methods: Cross-sectional design plus a longitudinal component, with a retrospective and prospective data collection. Consecutive patients, diagnosed with ascendant aortic aneurism or type A of Stanford aortic chronic dissection were included by means of hospital chart revision and data extraction. A total of 257 patients were recruited and eligibility criteria included those who underwent surgical procedures due to ascendant aortic aneurism or type A of Stanford aortic chronic dissection. Patients with acute aortic dissection and with aortic aneurism in a different segment location other than ascendant aorta were excluded. Clinical endpoints evaluated were death, clinically relevant bleeding, ventricular dysfunction and neurological complications, during the hospital phase and long-term death. Prognostic variables evaluated included: demography, pre-operative factors, intra-operative factors and post-operative complications. Mean follow up was of 970 days. Sample size estimation was defined by a convenience sample along with previous publications. Univariate analysis was conducted to select key variables to be inserted in the multivariate model and to identify the prognostic variables independently associated with clinically relevant endpoints. Results: The following prognostic variables have been identified as independently associated with increased risk of hospital death (OR; 95%IC; P value): black ethnicity (6.8; 1.54-30.2; 0,04), cerebrovascular disease (10.5; 1.12-98.7; 0,04), hemopericardium (35.1; 3.73-330.2; 0,002), Cabrol operation (9.9; 1.47-66.36; 0,019), associated coronary artery bypass graft (4.4; 1.31-15.06; 0,017), reoperation for bleeding (5.72; 1.29-25.29; 0,021) and cardiopulmonary bypass time (CPB) [min] (1.016; 1.007-1.026; 0,001). Presence of chest pain was independently associated with reduced risk of hospital death (0.27; 0.08-0.94; 0,04). The following variables were independently associated with increased risk of composite clinical endpoint during hospital phase: antifibrinolitic use (3.2; 1.65-6.27; 0,0006), renal failure (7.4; 1.52-36.0; 0,013), respiratory failure (3.7; 1.5-8.8; 0,004), EuroScore (1.23; 1.08-1,41; 0,003) and cardiopulmonary bypass time (CPB) [min] (1.01; 1.00-1.02; 0,027). The following variables were independently associated with increased risk of long term death: peripheral obstructive arterial disease (7.5;1.47-37.85;0,015), previous stroke (7.0;1.46-33.90;0,015), at discharge statin use (4.9;1.17-21.24;0,029) and first 24-hour increased bleeding (1.0017;1.0003-1.0032;0,021). Conclusion: Black ethnicity, cerebrovascular disease, hemopericadium, Cabrol operation, associated coronary artery bypass graft, reoperation for bleeding, and cardiopulmonary bypass time were associated with increased risk of hospital death. Presence of chest pain was associated with reduced risk of hospital death. Peripheral obstructive arterial disease, previous stroke, at discharge statin use and first 24-hour increased bleeding were associated with increase risk of long-term death. Use of antifibrinolitic, renal failure, respiratory failure, EuroScore and cardiopulmonary bypass time were associated with increased risk of hospital composite clinical endpoint (death, bleeding, ventricular dysfunction and neurological complications).
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Rödel, Ana Paula Porto. "USO DE UM ESCORE DERIVADO DO HEMOGRAMA NA PREDIÇÃO DE RISCO DE PACIENTES SUBMETIDOS À CIRURGIA CARDÍACA COM CIRCULAÇÃO EXTRACORPÓREA." Universidade Federal de Santa Maria, 2015. http://repositorio.ufsm.br/handle/1/6027.

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Some CBC parameters have been implicated in individual susceptibility to death, both in heart disease and cardiac surgery populations. The cellular elements of blood are widely affected during cardiopulmonary bypass (CPB), technique used in cardiac surgery. A Complete Blood Count called Risk Score (CBC-RS) was calculated from the average of the deviations of the various elements of the CBC and has been previously validated and published. The CBC-RS showed as excellent predictor of death from all causes in large healthy and cardiovascular risk populations. Despite the effect of CPB on the blood cells, there is no acknowledgement from the prior assessment of this score in the surgical setting. The aim of this study was to evaluate the role of CBC-RS in the surgical risk prediction (mortality and morbidity) in patients undergoing cardiac surgery with CPB. For this, it was evaluated a historical cohort of 428 patients undergoing cardiac surgery with CPB. The individual CBC-RS was calculated using the collected blood count of patients preoperatively. Logistic regression and statistical C analyzed the predictive accuracy of this score. The primary endpoint was in-hospital mortality (all-cause) and secondary outcomes included the majors and bleeding complications. In our study, CBC-RS was a predictor of hospital mortality (OR = 1.28 for each score increments, 95% CI = 1123-1458, p <0.001) and secondary outcomes (OR = 1.208, 95% CI = 1.103 to 1.323, p <0.001). The areas under the curve (AUC) was 0.697 (p <0.001) and 0.636 (p <0.001) for both the primary and secondary endpoints, respectively. In multivariate analysis, after adjustment for other risk predictors (EuroSCORE II and CPB time), the CBC-RS remained significant and was the strongest predictor of mortality. Therefore, the CBC-RS proved to be an independent predictor of mortality and surgical complications during hospitalization. It may be a useful tool in risk assessment of patients undergoing cardiac surgery.
Dentre os diversos parâmetros fornecidos pelo hemograma, alguns já foram implicados em aumento da suscetibilidade individual à morte, tanto em pacientes com patologias cardíacas quanto os submetidos à cirurgia cardíaca. Os elementos celulares do sangue são amplamente afetados durante a circulação extracorpórea (CEC), técnica usada nas cirurgias cardíacas. Um escore calculado a partir dos desvios da média dos diversos componentes do hemograma foi previamente validado, publicado e chamado de Complete Blood Count Risk Score (CBC-RS). O CBC-RS se mostrou excelente preditor de morte por todas as causas em grandes populações saudáveis ou com fatores de risco cardiovascular. Apesar do efeito da CEC sobre as células sanguíneas, não se tem conhecimento da avaliação prévia deste escore no contexto cirúrgico. O objetivo do presente trabalho foi avaliar o papel do CBC-RS na predição de risco cirúrgico (mortalidade e morbidade hospitalar) em pacientes submetidos à cirurgia cardíaca com CEC. Para isso, uma coorte histórica de 428 pacientes submetidos à cirurgia cardíaca com CEC foi avaliada. O CBC-RS individual foi calculado utilizando o hemograma coletado dos pacientes no pré-operatório. A acurácia preditora deste escore foi analisada através regressão logística e estatística C. O desfecho primário avaliado foi a mortalidade hospitalar (por todas as causas) e os desfechos secundários incluíram as complicações maiores e sangramento. Em nosso estudo, o CBC-RS foi um preditor de mortalidade hospitalar (OR = 1,28 por cada aumento de pontuação do CBC-RS, IC 95% = 1.123 - 1.458, p <0,001) e dos desfechos secundários (OR = 1,208, IC 95% = 1,103 - 1,323, p <0,001). As áreas sob a curva (AUC) foram 0,697 (p <0,001) e 0,636 (p <0,001) para os desfechos primário e secundário, respectivamente. Na análise multivariada, após ajuste para preditores de risco pré-operatório (EuroSCORE II) e transoperatório (tempo de CEC) conhecidos, o CBC-RS permaneceu significativo e foi o preditor de mortalidade mais forte. Sendo assim, o CBC-RS se mostrou um preditor independente da mortalidade e complicações cirúrgicas no período hospitalar, podendo representar uma ferramenta útil na avaliação de risco de pacientes submetidos à cirurgia cardíaca.
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Riera, Sagrera María. "Cirugía cardiaca en el hospital universitario Son Dureta: Análisis de morbimortalidad y factores asociados." Doctoral thesis, Universitat de les Illes Balears, 2011. http://hdl.handle.net/10803/52187.

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La morbimortalidad de la cirugía cardiaca y el análisis de los factores pronósticos muestran resultados discrepantes. Se analizaron las complicaciones postoperatorias y la mortalidad hospitalaria y a medio plazo, en relación con la edad y otros factores de riesgo asociados. Se realizó en el hospital universitario Son Dureta (Palma de Mallorca), con una unidad de cuidados intensivos específica para dicho paciente. La mortalidad hospitalaria y a medio plazo fue menor, comparada con otras series. El Euroscore sobrevaloró la mortalidad global observada. La edad ≥70 años, la fracción de eyección preoperatoria <30%, la hipertensión pulmonar severa, la diabetes mellitus y la anemia preoperatoria fueron predictores independientes de mortalidad. La disfunción renal moderada preoperatoria fue un predictor independiente de morbilidad en la cirugía valvular. La neumonía nosocomial se asoció con una mayor mortalidad y un aumento del tiempo de ventilación mecánica y de la estancia en cuidados intensivos y hospitalaria.
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Mariscalco, Giovanni. "Atrial fibrillation after cardiac surgery : an analysis of risk factors, mechanisms, and survival effects." Doctoral thesis, Umeå universitet, Kirurgi, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1798.

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Background: Despite the recent improvements in surgical techniques and postoperative patient care, atrial fibrillation (AF) remains the most frequent complication after cardiac surgery. Although postoperative AF is often regarded as a benign clinical condition, this arrhythmia has significant adverse effects on patient recovery and postoperative survival. Its exact pathophysiology has not yet been elucidated. The present thesis aims to analyze AF risk factors and their interaction, pre-existing histological explanatory alterations of the atrium, the AF impact on postoperative survival and the compliance of a prophylactic drug regimen. Methods: During a 10-year period, consecutive cardiac surgery cases with complete data on AF occurrence and postoperative survival were extracted. All patients were operated on for coronary or valvular surgery, with cardiopulmonary bypass (CPB). Hospital and long-term survival data were obtained from Swedish population registry. Study I) Isolated coronary artery bypass grafting (CABG, n=7056), aortic valve replacement (n=690) and their combination (n=688) were considered. Independent AF risk factors and AF effects on early and 1 year mortality were investigated. Study II) Patients affected by postoperative AF among isolated CABG patients (n=7621), valvular surgeries (n=995) and their combination (n=879) were studied. Long-term survival was obtained and prognostic factors identified. Study III) Seventy patients were randomized to on-pump (n=35) or off-pump (n=35) CABG. Samples from the right atrial appendage were collected and histology was evaluated by means of light and electronic microscopy with reference to preexistent alterations related to postoperative AF. Study IV) Cardiac surgery patients with complete data on smoking status (n=3245) were reviewed. Effects of smoking on AF development and interaction among variables were explored. Study V) CABG patients without clinical contraindications to receive oral sotalol (80 mg twice daily) and magnesium were prospectively enrolled (n = 49) and compared with a matched contemporary control CABG group (n = 844). The clinical compliance to the AF prophylactic drug regimen was tested. Results: The overall AF incidence was around 26%, subdivided into 23%, 40% and 45% for isolated CABG, valve procedures and their combined surgeries, respectively. Age was the strongest predictor of postoperative AF. Coronary disease superimposed risk factors with reference to myocardial conditions at CPB weaning. Considering the preoperative smoking condition, smokers demonstrated a reduced AF incidence compared to non-smokers (20% versus 27%, p<0.001). An interaction between smoking status and inotropic support was observed: without this interaction smoking conferred a 46% risk reduction of AF (p=0.011). At the histological level, myocyte vacuolization and nuclear derangement represented anatomical independent AF predictors (p=0.002 and p=0.016, respectively). CPB exposure was not associated to postoperative AF nor histological changes. Although, postoperative AF increases the length of hospitalization in all patient groups, it did not affect the hospital survival. However, AF independently impaired the late survival, a phenomenon seen in the CABG group only. With reference to the tested sotalolmagnesium drug regimen, only 55% of CABG patients were compliant to the treatment, with marginal effects on AF occurrence. Conclusions: In addition to age, details at the CPB weaning period, pre-existing histopathological changes, the hyperadrenergic state and catecholamines are key mechanisms in the pathophysiology of postoperative AF. In particular, the CPB period hides valuable information for timely AF prophylactic stratifications. Further, compliance effects due to patient selection should also be considered in a prophylactic therapy model. Postoperative AF increases late mortality after isolated CABG surgery, but not after valvular procedures. Although the mechanisms are unclear, our results draw the attention to possible AF recurrence after hospital discharge, indicating a strict postoperative surveillance.
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Books on the topic "Cardiac surgery mortality"

1

Sinclair, C. M. The report of the Manitoba Pediatriac [sic] Cardiac Surgery Inquest: An inquiry into twelve deaths at the Winnipeg Health Sciences Centre in 1994. [Winnipeg]: Provincial Court of Manitoba, 2000.

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Pepper, John. Cardioprotection During Cardiac Surgery. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199544769.003.0007.

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• Overall early mortality for cardiac surgery is low at 2–3% but in high risk patients it can be high as 10–15%• The demography of cardiac surgical patients is changing to older and sicker patients• Myocardial ischaemia-reperfusion injury and the systemic inflammatory response are closely related• Several pharmacological agents that have been demon-strated to confer cardioprotection in the experimental setting have been applied to the clinical setting of cardiac surgery. However, the transfer of these findings from the bench to the bedside has been largely disappointing• Potential cardioprotective strategies include pharma-cological agents such as adenosine, and mechanical interventional strategies such as acute normovolaemic haemodilution and remote ischaemic preconditioning.
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Brown, Jeremiah R., and Chirag R. Parikh. Cardiovascular surgery and acute kidney injury. Edited by Norbert Lameire. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0245.

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Over the last decade, cardiac surgery-associated acute kidney injury (AKI) has been recognized as a frequent adverse event following cardiac surgery. In this clinical context and others, AKI has been strongly associated with increased morbidity, mortality, and length of hospitalization. These adverse events that accompany AKI have been shown to be directly proportional to the magnitude of the peak rise in serum creatinine and the duration of AKI making AKI a costly complication and a target for prevention in hospitalized patients around the world. This chapter discusses the subsequent healthcare costs, utilization, mortality, and morbidity that follow subtle changes in serum creatinine known as AKI in the perioperative setting of cardiac surgery.
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Balik, Martin. Perioperative cardiac care of the high-risk non-cardiac patient. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0076.

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Non-cardiac surgery conveys a cardiac risk related to the status of the patient’s cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additional tests. The indications for further cardiac testing and treatments are the same as in the non-operative setting, but their timing is dependent on the urgency of surgery, and patient-specific and surgical risk factors. A delay in surgery, due to the use of both non-invasive and invasive preoperative testing, should be limited to those circumstances in which the results of such tests will clearly affect patient management. In high-risk patients, the result of the cardiac assessment helps to choose adequate perioperative monitoring and to indicate for an intensive care unit stay perioperatively. Chronic medications can be adjusted, according to the current knowledge on perioperative management. Drugs with the potential to reduce the incidence of post-operative cardiac events and mortality include beta-blockers, statins, and aspirin. Chronic platelet anti-aggregation and anticoagulation therapies have to be adapted by weighing the risk of bleeding against the risk of thrombotic complications.
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Balik, Martin. Perioperative cardiac care of the high-risk non-cardiac patient. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0076_update_001.

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Non-cardiac surgery conveys a cardiac risk related to the status of the patient’s cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additional tests. The indications for further cardiac testing and treatments are the same as in the non-operative setting, but their timing is dependent on the urgency of surgery, and patient-specific and surgical risk factors. A delay in surgery, due to the use of both non-invasive and invasive preoperative testing, should be limited to those circumstances in which the results of such tests will clearly affect patient management. In high-risk patients, the result of the cardiac assessment helps to choose adequate perioperative monitoring and to indicate for an intensive care unit stay perioperatively. Chronic medications can be adjusted, according to the current knowledge on perioperative management. Drugs with the potential to reduce the incidence of post-operative cardiac events and mortality include beta-blockers, statins, and aspirin. Chronic platelet anti-aggregation and anticoagulation therapies have to be adapted by weighing the risk of bleeding against the risk of thrombotic complications.
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Balik, Martin. Perioperative cardiac care of the high-risk non-cardiac patient. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0076_update_002.

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Non-cardiac surgery conveys a cardiac risk related to the status of the patient’s cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additional tests. The indications for further cardiac testing and treatments are the same as in the non-operative setting, but their timing is dependent on the urgency of surgery, and patient-specific and surgical risk factors. A delay in surgery, due to the use of both non-invasive and invasive preoperative testing, should be limited to those circumstances in which the results of such tests will clearly affect patient management. In high-risk patients, the result of the cardiac assessment helps to choose adequate perioperative monitoring and to indicate for an intensive care unit stay perioperatively. Chronic medications can be adjusted, according to the current knowledge on perioperative management. Drugs with the potential to reduce the incidence of post-operative cardiac events and mortality include beta-blockers, statins, and aspirin. Chronic platelet anti-aggregation and anticoagulation therapies have to be adapted by weighing the risk of bleeding against the risk of thrombotic complications.
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Taggart, David, and Yasir Abu-Omar. Heart surgery. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0098.

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Cardiac surgery is still a relatively young specialty, having been developed only in the latter half of the twentieth century with the introduction of extracorporeal circulation or ‘cardiopulmonary bypass’ (CPB). This initiated the era of open heart surgery, initially allowing the repair of congenital heart defects, then valve replacements, coronary artery bypass grafting (CABG), and, finally, heart transplantation. Over the last two decades, improvements in medical, anaesthetic, and surgical management of patients, allied to refinements in extracorporeal perfusion technology, have resulted in a decreasing mortality and morbidity from heart surgery despite the advanced age and significant comorbidity of many patients. Today, heart surgery continues to improve the prognosis and quality of lives of patients around the world. Surgical techniques and technologies continue to evolve and recent years have witnessed the emergence of, amongst others, the use of long-lasting conduits for CABG procedures, beating-heart (‘off-pump’) surgery, the use of minimally invasive and robotic techniques, and long-term mechanical circulatory support.
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AlJaroudi, Wael. Risk Assessment Before Noncardiac Surgery. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0014.

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Perioperative risk assessment is essential in screening patients before noncardiac surgery. Cardiovascular complications such as fatal and non-fatal myocardial infarction (MI), ventricular arrhythmia, pulmonary edema, and stroke are important in-hospital causes of morbidity and mortality intra and post-operatively. The optimal approach is to identify patients at increased risk so that appropriate testing and therapeutic interventions are undertaken a priori to minimize such risk. The initial preoperative evaluation includes identification of surgery-specific risk, patient exercise functional capacity and clinical risk profile. Patients with major predictors of events such as acute coronary syndromes, recent MI, unstable arrhythmia, and severe valvular disease warrant further management and optimization that often lead to delaying surgery. Those with three or more predictors (history of ischemic heart disease, compensated heart failure, diabetes, renal insufficiency, or history of cerebrovascular disease) undergoing high- risk surgery often require stress testing. Although data from randomized prospective trials are lacking, numerous studies have demonstrated the utility of myocardial perfusion imaging (MPI) for determination of perioperative cardiac risk. The goal of this chapter is to review the use of MPI for preoperative risk assessment and the recommendations from the current guidelines. The focus will be on short-term and long-term prognosis including special groups such as after coronary stenting and before vascular surgery, liver and renal transplantation.
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AlJaroudi, Wael. Myocardial Perfusion Imaging Before and After Cardiac Revascularization. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0015.

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Coronary artery disease (CAD) remains the leading cause of morbidity and mortality worldwide. While the burden of the disease remains high, the rates of death attributable to CAD have declined by almost a third between 1998 and 2008. In patients with stable ischemic heart disease (SIHD), data supporting survival benefit from coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI) versus no revascularization are outdated with the recent advancement in medical therapy. Over the years, myocardial perfusion imaging (MPI) has played a significant role in detecting ischemic burden, risk stratifying patients and guiding physicians to the best treatment strategy. Contrary to data from other trials, the role of stress MPI has been downplayed in more contemporary randomized clinical trial that failed to show that ischemic burden identifies the ideal candidate for revascularization or carries incremental prognostic value. Hence, there is an equipoise on the role of MPI in the management of patients prior to revascularization. The role of stress MPI post-revascularization has also been evaluated in multiple studies, mostly done in the last decade or prior. The guidelines advocate against routine stress MPI in asymptomatic patients (unless 5 years or more post-CABG), but allows it in the presence or recurrence of symptoms. The current chapter will review the data on survival benefit from revascularization, complementary role of stress MPI in selecting the appropriate candidate for revascularization, prognostic value of ischemic versus atherosclerotic burden, role of MPI post revascularization, updated guidelines and proposed algorithms to guide the treating physicians.
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Hert, Stefan De, and Patrick Wouters. Heart disease and anaesthesia. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0083.

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Cardiovascular disease is a leading cause of mortality. Hypertension is one of the major risk factors for cardiovascular disease. Classically, hypertension is subdivided according to the aetiology into primary and secondary hypertension. Ischaemic heart disease constitutes a major concern for perioperative morbidity and mortality. Therefore important efforts are directed towards the identification of the patient at risk for perioperative cardiac complications and towards optimization of the cardiac status before intervention. Cardiac rhythm disturbances fall into two general classes: bradyarrhythmias and tachyarrhythmias. While single isolated extra or skipped heart beats are usually harmless, serious heart rhythm disturbances are caused by an underlying heart disease. Valvular heart disease refers to any disease process involving any valve of the heart. Valvular heart disease may be as a result of a stenosis or an insufficiency of the valve, or both. It is characterized by pressure or volume overload to the atria and the ventricles (or both). It is this overload that will be responsible for the symptomatology of the disease. As a result of significant advances in prenatal diagnosis, cardiac surgery, interventional cardiology, and perioperative medicine, about 90% of infants with congenital heart disease are currently expected to reach adulthood. Management of these patients requires insight into (1) the primary cardiac lesion, (2) the type of cardiac surgical or interventional procedure(s) performed, (3) the presence of residual defects or sequelae, (4) the current physical status (i.e. balanced vs unbalanced), (5) the effects of surgery or pregnancy on their pathophysiological condition, and (6) the presence of comorbidity.
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Book chapters on the topic "Cardiac surgery mortality"

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Garb, Jane L., Richard M. Engelman, John A. Rousou, Joseph E. Flack, David W. Deaton, Marie Mclntire, and Albert W. Peng. "Hospital Mortality and Cost following Coronary Artery Bypass Procedures." In Cardiac Surgery, 77–92. Boston, MA: Springer US, 1995. http://dx.doi.org/10.1007/978-1-4615-1925-6_8.

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Parotto, Matteo, and Duminda N. Wijeysundera. "N-acetylcysteine to Reduce Mortality in Cardiac Surgery." In Reducing Mortality in Acute Kidney Injury, 101–6. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-33429-5_12.

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Capasso, Antonella, Federico Masserini, and Antonio Pisano. "Leukocyte Depletion of Transfused Blood May Reduce Mortality in Cardiac Surgery Patients." In Reducing Mortality in the Perioperative Period, 63–71. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-46696-5_9.

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Thiagarajan, Ravi R., and Peter C. Laussen. "Risk Adjustment for Congenital Heart Surgery -1 (RACHS-1) for Evaluation of Mortality in Children Undergoing Cardiac Surgery." In Pediatric and Congenital Cardiac Care, 327–36. London: Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6587-3_26.

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Jacobs, Marshall L., Sara K. Pasquali, Jeffrey P. Jacobs, and Sean M. O’Brien. "Empirically Based Tools for Analyzing Mortality and Morbidity Associated with Congenital Heart Surgery." In Pediatric and Congenital Cardiac Care, 363–75. London: Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6587-3_28.

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Leape, Lucian L. "Partners in Progress: Patient Safety in the UK." In Making Healthcare Safe, 203–13. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-71123-8_13.

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AbstractIn 1997, Britons were shocked by a report from the General Medical Council (GMC) of a series of deaths from bungled surgery at the Bristol Royal Infirmary. In response to parents’ complaints, the GMC had launched an investigation into the high mortality of cardiac surgery of children at the Infirmary. It found that of 53 children who were operated on, 29 had died and 4 suffered severe brain damage. Three surgeons were found guilty of serious professional misconduct, and two were stricken from the medical register [1].
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Vamvakas, Eleftherios C. "Transfusion-Related Immunomodulation (TRIM): From Renal Allograft Survival to Postoperative Mortality in Cardiac Surgery." In Respiratory Medicine, 241–59. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-41912-1_13.

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Miller, D. Craig. "Acute Type A Aortic Dissection and Early Hazard Mortality: New Statistical Approaches and Room for Improvement." In Cardio-aortic and Aortic Surgery, 237–39. Tokyo: Springer Japan, 2001. http://dx.doi.org/10.1007/978-4-431-65934-1_37.

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Hulse, Matthew, and Stuart Lowson. "Risk Assessment Scores in Cardiac Surgery." In Cardiothoracic Critical Care, 1–12. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190082482.003.0001.

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This chapter discusses the importance of cardiac surgical risk scoring models in classifying risk in adult patients. These scores first came into construct in the 1980s when the rate of mortality following coronary bypass graft surgery began to increase. Since this time, numerous scoring systems have been developed to define patient risk factors. The first widely used risk model was the initial Parsonnet score developed in 1989, which predicted cardiac surgical mortality based on preoperative risk factors thought to be clinically significant. Today, the most commonly used risk assessment tools for cardiac surgical patients are the European System for Cardiac Operative Risk Evaluation II and the Society of Thoracic Surgeons risk score. However, neither of these 2 major scoring systems assesses frailty. Frailty is consistently associated with a greater risk of morbidity and mortality in patients undergoing transcatheter aortic valve replacement procedures. The risk associated with frailty following open cardiac surgical procedures is less clear.
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Katz, Jason Neil, and Edward J. Sawey. "Epidemiology of Cardiac Surgery and the Cardiac Surgical Patient." In Coronary and Cardiothoracic Critical Care, 266–80. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-8185-7.ch014.

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While the timeline has been relatively abbreviated, there has been significant evolution in the field of cardiac surgery. These changes have been driven by a combination of operative innovation, changing patient demographics, and novel critical care resources, all of which have allowed today's surgeons to treat a myriad of conditions among increasingly higher risk patient cohorts. At the same time, this has forced providers to expand their clinical skill sets, embrace multidisciplinary collaboration, enhance postoperative care, and intensify the rigor by which outcomes and quality are being measured. In spite of this increasing complexity, however, mortality in cardiac surgery continues to improve. In this chapter, we highlight key historical events and describe an unprecedented trajectory and evolution in care practices that have helped shape modern cardiac surgery. We also make an appeal for additional research efforts which are needed to ensure sustained and innovative growth.
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Conference papers on the topic "Cardiac surgery mortality"

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Demal, J. T., S. Pecha, L. Castro, J. Vogler, N. Gosau, M. Linder, S. Willems, H. Reichenspurner, and S. Hakmi. "In-Hospital Mortality after Transvenous Lead Extraction." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678795.

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Kalyana Raman, Supraja, Rohit Anusha, Parthasarathy Rajeevalochana, Soundar Sharmila, Shree Shenbagavalli, and Murugan Santhalakshmi. "Predictors of mortality in VAP following cardiac surgery – adult and pediatric." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa4082.

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Westhofen, S., R. Stiefel, E. Vettorazzi, H. Reichenspurner, and C. Detter. "In-hospital Outcome and Risk Predictors of Mortality after Redo Aortic Valve Surgery." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678764.

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Djordjevic, I., K. Eghbalzadeh, S. Heinen, G. Schlachtenberger, C. Weber, A. Sabashnikov, N. Mader, Y. H. Choi, O. Liakopoulos, and T. Wahlers. "Risk Factors Associated with In-hospital Mortality for Patients with Acute Abdomen after Cardiac Surgery." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678849.

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Sievers, H. H., A. Baier, F. Beyersdorf, M. Czerny, M. Kreibich, M. Siepe, and B. Rylski. "Aortic Dissection Rethought: A New Classification System Adding Clarity and Allowing Prediction of In-Hospital Mortality." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678940.

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Diab, M., R. Tasar, C. Sponholz, M. Bauer, T. Lehmann, G. Faerber, F. Brunkhorst, and T. Doenst. "Can Preoperative Measurement of Mid-regional Proadrenomedullin Predict Postoperative Organ Dysfunction and Mortality in Patients Undergoing Valvular Surgery?" In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678808.

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Pollari, F., J. Kališnik, F. Vogt, K. Steblovnik, C. Dormann, J. Jessl, T. Fischlein, and S. Pfeiffer. "Simplified Acute Physiology Score II Predicts Mortality and Length of Stay Better than EuroSCOREs in Patients Undergoing Transcatheter Aortic Valve Implantation: A Single-Center Experience." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1679013.

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Dixon, Barry, David Reid, Marnie Collins, Alex Rosalion, Andrew Newcomb, Michael Yii, Ian Nixon, John D. Santamaria, and Duncan Campbell. "Chest Tube Bleeding Has A Dose Dependent Relationship With Hemodynamic Features Of Cardiac Tamponade And Mortality Following Cardiac Surgery." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a3162.

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Fujita, B., T. Schmidt, S. Bleiziffer, T. Bauer, A. Beckmann, R. Bekeredjian, H. Möllmann, et al. "Incidence of new Permanent Pacemaker Implantation after Surgical Aortic Valve Replacement and Transcatheter Aortic Valve Implantation and Its Impact on 1-Year Mortality—Insights from the German Aortic Valve Registry." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678890.

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Nellessen, U., S. Jost, H. Hecker, S. Specht, V. Danciu, and P. R. Lichtlen. "FIVE-YEAR-FOLLOW-UP OF PATIENTS WITH UNSTABLE ANGINA: SURGICAL VERSUS MEDICAL TREATMENT." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643006.

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Abstract:
Among patients (pts) with coronary artery disease those with symptoms of an unstable angina pectoris form a subset particularly jeopardized with regard to threatening myocardial infarction (MI) or cardiac death (CD). We analyzed over 5.4±2.1 years (Y) the clinical course of 123 pts, who between 1977 and 1982 had to be admitted to the intensive care unit for reasons of persisting angina at rest. Within the first 24 hours no patient revealed a significant elevation of serum creatine kinase or typical alterations in the ECG due to acute MI (new Q-waves). During their stay in hospital (19±17 days) 43 pts (37 men, 6 women; age 58±7 Y) were subjected to bypass graft surgery, 80 pts (60 men, 20 women; age 58jh10 Y) were medically treated, 13 of whom underwent subsequent bypass graft surgery because of aggravation of symptoms. The table presents a survey of cardiac mortality and incidence of MI in the collectives with medical and surgical treatment during the stay in hospital and 1, 3 and 5 Y after dismissal (calculated according to the life-table method of Kaplan-Meier).Hence, during the initial hospitalization infarction and mortality rate in the medically treated group indeed were smaller than in the surgical collective; however, after dismissal this beneficial mortality rate turned into the opposite in the course of the following years. In this group nearly every MI was fatal.
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