Predictors of Mortality Following Aortic Valve Replacement in Aortic Stenosis Patients.
Pathophysiology
; 29(1): 106-117, 2022 Mar 09.
Article
em En
| MEDLINE
| ID: mdl-35366293
ABSTRACT
Background:
Understanding of the risk factors for the development of adverse outcomes after aortic valve replacement is necessary to develop timely preventive measures and to improve the results of surgical treatment.Methods:
We analyzed patients with aortic stenosis (n = 742) who underwent surgical treatment in the period 2014−2020. The average age was 63 (57;69) yearsmen 58%, women 42%.Results:
The hospital mortality rate was 3% (22 patients). The following statistically significant threshold values (cut-off points) were obtained in the ROCanalysis:
aortic cross-clamp time > 93 min AUC (CI) 0.676 (0.640−0.710), p = 0.010; cardiopulmonary bypass time > 144 min AUC (CI) 0.809 (0.778−0.837), p < 0.0001, hemoglobin before op <120 g/L. AUC (CI) 0.762 (0.728−0.793), p < 0.0001, hematocrit before op <39% AUC (CI) 0.755 (0.721−0.786), p < 0.001, end-diastolic dimension index >2.39 AUC (CI) 0.647 (0.607−0.686), p = 0.014, end-systolic dimension index > 1.68 AUC (CI) 0.657 (0.617−0.695), p = 0.009. Statistically significant independent predictors of hospital mortality were identified BMI > 30 kg/m2 (OR 2.84; CI 1.15−7.01), ischemic heart disease (OR 3.65; CI 1.01−13.2), diabetes (OR 3.88; CI 1.38−10.9), frequent ventricular ectopy before operation (OR 9.78; CI 1.91−50.2), mitral valve repair (OR 4.47; CI 1.76−11.3), tricuspid valve repair (OR 3.06; CI 1.09−8.58), 3 and more procedures (OR 4.44; CI 1.67−11.8).Conclusions:
The hospital mortality rate was 3%. The main indicators associated with the risk of death were diabetes, overweight (body mass index more than 30 kg/m2), frequent ventricular ectopy before surgery, hemoglobin level below 120 g/L, hematocrit level below 39%, longer cardiopulmonary bypass time and aortic cross-clamp time, additional mitral and tricuspid valve interventions.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Pathophysiology
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Federação Russa