PMID- 23162397
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20121120
LR  - 20211021
IS  - 0975-3125 (Electronic)
IS  - 1658-354X (Print)
VI  - 6
IP  - 3
DP  - 2012 Jul
TI  - Perioperative predictors of morbidity and mortality following cardiac surgery 
      under cardiopulmonary bypass.
PG  - 242-7
LID - 10.4103/1658-354X.101215 [doi]
AB  - BACKGROUND: Prediction of outcome after cardiac surgery is difficult despite a 
      number of models using pre-, intra- and post-operative factors. Ideally, risk 
      factors operating in all three phases of the patients' stay in the hospital 
      should be incorporated into any outcome prediction model. The aim of the present 
      study was to identify the perioperative risk factors associated with morbidity, 
      mortality and length of stay in the recovery room (LOSR) and length of stay in 
      the hospital (LOSH). METHODS: Eighty-eight adults of either sex, patients 
      undergoing elective open cardiac surgery were studied prospectively. The ability 
      of a number of pre-, intra- and post-operative factors to predict outcome in the 
      form of mortality, immediate morbidity (LOSR) and intermediate morbidity (LOSH) 
      was assessed. RESULTS: Factors associated with higher mortality were preoperative 
      prothrombin index (PTI), American Society of Anesthesiology-Physical Status 
      (ASA-PS) grade, Cardiac Anaesthesia Risk Evaluation (CARE) score and New York 
      Heart Association (NYHA) class, intraoperative duration of cardiopulmonary bypass 
      (DCPB), number of inotropes used while coming off cardiopulmonary bypass and 
      postoperatively, Acute Physiology and Chronic Health Evaluation (APACHE) II 
      excluding the Glassgow Comma Scale (GCS) component and the number of inotropes 
      used. Immediate morbidity was associated with preoperative PTI, inotrope usage 
      intra- and post-operatively and the APACHE score. Intermediate morbidity was 
      associated with DCPB and intra- and post-operative inotrope usage. Individual 
      surgeon influenced the LOSR and the LOSH. CONCLUSION: APACHE score, a general 
      purpose severity of illness score, was relatively ineffective in the 
      postoperative period because of sedation, neuromuscular blockade and elective 
      ventilation used in a number of these patients. The preoperative and 
      intraoperative factors like CARE, ASA-PS grade, NYHA, DCPB and number of 
      inotropes used influencing morbidity and mortality are consistent with the 
      literature, despite the small size of our sample.
FAU - Bhukal, Ishwar
AU  - Bhukal I
AD  - Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical 
      Education and Research, Chandigarh, India.
FAU - Solanki, Sohan Lal
AU  - Solanki SL
FAU - Ramaswamy, Shankar
AU  - Ramaswamy S
FAU - Yaddanapudi, Lakshmi Narayana
AU  - Yaddanapudi LN
FAU - Jain, Amit
AU  - Jain A
FAU - Kumar, Pawan
AU  - Kumar P
LA  - eng
PT  - Journal Article
PL  - India
TA  - Saudi J Anaesth
JT  - Saudi journal of anaesthesia
JID - 101500601
PMC - PMC3498662
OTO - NOTNLM
OT  - Cardiac surgery
OT  - outcome prediction
OT  - prognostication
OT  - risk stratification
COIS- Conflict of Interest: None declared.
EDAT- 2012/11/20 06:00
MHDA- 2012/11/20 06:01
PMCR- 2012/07/01
CRDT- 2012/11/20 06:00
PHST- 2012/11/20 06:00 [entrez]
PHST- 2012/11/20 06:00 [pubmed]
PHST- 2012/11/20 06:01 [medline]
PHST- 2012/07/01 00:00 [pmc-release]
AID - SJA-6-242 [pii]
AID - 10.4103/1658-354X.101215 [doi]
PST - ppublish
SO  - Saudi J Anaesth. 2012 Jul;6(3):242-7. doi: 10.4103/1658-354X.101215.