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ISSN 2448-8909 (Print)

2023, Number 7

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Med Crit 2023; 37 (7)

Risk factors associated with mortality of patients undergoing cardiac surgery

Castañeda OE, Trejo AA, Cerón DUW

Language: Spanish
References: 20
Page: 552-558
PDF size: 239.60 Kb.


ABSTRACT

Introduction: cardiac diseases represent the leading cause of death. Despite advances in minimally invasive surgery and percutaneous procedures, cardiac surgery remain as an option in the most complex cases, even though it has a high probability of morbidity and mortality, and there are multiple preoperative, intraoperative and immediate postoperative factors associated with poor outcomes. Objective: to determine the factors associated with mortality in patients undergoing cardiac surgery and to construct a predictive model. Material and methods: a retrolective, cross-sectional, analytical study of patients admitted to the Intensive Care Unit (ICU) after cardiac surgery with extracorporeal circulation during January 1, 2017 to August 31, 2023. Results: data from 70 patients were analyzed, a mortality of 8.57% was determined, mean age 60.6 ± 11.5 years and 78.5% were male. The most frequent procedure was coronary revascularization surgery (64.3%). Univariate analysis showed association to mortality mainly with days of mechanical ventilation (0.12 vs 1.12, p = 0.01), days of in-hospital stay (13.82 vs 2.86, p = 0.01), cardiac power (0.87 vs 0.55, p = 0.01), beat volume index (55.8 vs 29.3, p = 0.001), lactate (2.25 vs 7.5, p ≤ 0.0001), troponin I (77.8 vs 1,381.1, p = 0.01), report of trans-operative complication (7.1% vs 50%, p = 0.001) and infusion of inotropes and vasopressors at admission (44.3% vs 100%, p = 0.015). A binary logistic regression showed that only lactate (OR 2.476, 95% CI [1.25-4.88]) and troponin I (OR 1.0, 95% CI [1.000-1.001]) have an independent association with mortality. A predictive model for mortality was developed and ROC analysis was performed with an AUR 0.969 [0.920-1.017]. Conclusions: there are different factors associated with mortality, in our case after logistic regression analysis only lactate and troponin I were independently associated. Our predictive model is simple and could be a tool to predict mortality on the initial approach.


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