Outcome analysis for prediction of early and long-term survival in patients receiving intra-aortic balloon pumping after cardiac surgeryReportar como inadecuado




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General Thoracic and Cardiovascular Surgery

, Volume 64, Issue 10, pp 584–591

First Online: 25 July 2016Received: 13 February 2016Accepted: 21 June 2016

Abstract

BackgroundPatients requiring an intra-aortic balloon pump IABP after cardiac surgery are critically ill and need a prolonged ICU stay. Considering limited health care resources, the early identification of patients with an extremely poor prognosis is important as a solid base for the decision whether further aggressive continuation or cessation of the therapy is recommendable.

MethodsFrom 2001 to 2007, 552 patients with low-output syndrome after open-heart surgery and IABP implantation in OR or within 24 h thereafter on ICU were retrospectively analyzed.

ResultsThe overall mortality at 30 and 180-day were 31 and 40 %, respectively. According to multivariate analyses, following factors were used to generate an IABP score: female gender, age ≥70 years, simultaneous coronary and valve surgery, aortic cross-clamp time >120 min., need of norepinephrin more than 0.4 µg kg min, postoperative dialysis, and maximal serum creatinine kinase >3000 mg mL. The 30-day mortality continuously increased along the score 10.1 % for score = 0, n = 98; 11.8 % for score = 1, n = 144; 27.5 % for score = 2, n = 153; 40.4 % score = 3, n = 89; 65.2 % for score = 4, n = 46; 77.8 % for score = 5, n = 27 and reached 100 % for all patients with a score of 6 n = 4.

ConclusionsPrediction of 30 days mortality was possible with our scoring system based on multivariate analysis, and patients with scores of 4 or greater had remarkably worse early and late survival.

KeywordsCardiac surgery Low output syndrome Intraaortic balloon pumping M. Schilling and H. Kamiya contributed equally to this article.

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Autor: Hiroyuki Kamiya - Maximilian Schilling - Payam Akhyari - Arjang Ruhparwar - Klaus Kallenbach - Matthias Karck - Artur Licht

Fuente: https://link.springer.com/



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