PMID- 37629658
OWN - NLM
STAT- MEDLINE
DCOM- 20230828
LR  - 20230829
IS  - 1648-9144 (Electronic)
IS  - 1010-660X (Print)
IS  - 1010-660X (Linking)
VI  - 59
IP  - 8
DP  - 2023 Jul 26
TI  - Three Logistic Predictive Models for the Prediction of Mortality and Major 
      Pulmonary Complications after Cardiac Surgery.
LID - 10.3390/medicina59081368 [doi]
LID - 1368
AB  - Background and Objectives: Pulmonary complications are a leading cause of 
      morbidity after cardiac surgery. The aim of this study was to develop models to 
      predict postoperative lung dysfunction and mortality. Materials and Methods: This 
      was a single-center, observational, retrospective study. We retrospectively 
      analyzed the data of 11,285 adult patients who underwent all types of cardiac 
      surgery from 2003 to 2015. We developed logistic predictive models for 
      in-hospital mortality, postoperative pulmonary complications occurring in the 
      intensive care unit, and postoperative non-invasive mechanical ventilation when 
      clinically indicated. Results: In the "preoperative model" predictors for 
      mortality were advanced age (p < 0.001), New York Heart Association (NYHA) class 
      (p < 0.001) and emergent surgery (p = 0.036); predictors for non-invasive 
      mechanical ventilation were advanced age (p < 0.001), low ejection fraction (p = 
      0.023), higher body mass index (p < 0.001) and preoperative renal failure (p = 
      0.043); predictors for postoperative pulmonary complications were preoperative 
      chronic obstructive pulmonary disease (p = 0.007), preoperative kidney injury (p 
      < 0.001) and NYHA class (p = 0.033). In the "surgery model" predictors for 
      mortality were intraoperative inotropes (p = 0.003) and intraoperative 
      intra-aortic balloon pump (p < 0.001), which also predicted the incidence of 
      postoperative pulmonary complications. There were no specific variables in the 
      surgery model predicting the use of non-invasive mechanical ventilation. In the 
      "intensive care unit model", predictors for mortality were postoperative kidney 
      injury (p < 0.001), tracheostomy (p < 0.001), inotropes (p = 0.029) and 
      PaO(2)/FiO(2) ratio at discharge (p = 0.028); predictors for non-invasive 
      mechanical ventilation were kidney injury (p < 0.001), inotropes (p < 0.001), 
      blood transfusions (p < 0.001) and PaO(2)/FiO(2) ratio at the discharge (p < 
      0.001). Conclusions: In this retrospective study, we identified the preoperative, 
      intraoperative and postoperative characteristics associated with mortality and 
      complications following cardiac surgery.
FAU - Bignami, Elena
AU  - Bignami E
AD  - Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine 
      and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy.
FAU - Guarnieri, Marcello
AU  - Guarnieri M
AUID- ORCID: 0000-0002-1922-6996
AD  - Department of Anesthesia and Intensive Care, Grande Ospedale Metropolitano 
      Niguarda, 20162 Milan, Italy.
FAU - Giambuzzi, Ilaria
AU  - Giambuzzi I
AUID- ORCID: 0000-0003-3889-2406
AD  - Department of Cardiovascular Surgery, Centro Cardiologico Monzino-IRCCS, 20122 
      Milan, Italy.
AD  - Department of Clinical and Community Sciences, DISCCO University of Milan, 20126 
      Milan, Italy.
FAU - Trumello, Cinzia
AU  - Trumello C
AUID- ORCID: 0000-0003-2410-3218
AD  - Department of Cardiac Surgery, IRCCS San Raffaele Scientific Institute, 20132 
      Milan, Italy.
FAU - Saglietti, Francesco
AU  - Saglietti F
AUID- ORCID: 0000-0002-8767-6577
AD  - Department of Anesthesia and Intensive Care, Azienda Ospedaliera Santa Croce e 
      Carle, 12100 Cuneo, Italy.
FAU - Gianni, Stefano
AU  - Gianni S
AD  - Department of Anesthesia and Intensive Care, Grande Ospedale Metropolitano 
      Niguarda, 20162 Milan, Italy.
FAU - Belluschi, Igor
AU  - Belluschi I
AD  - Department of Cardiac Surgery, IRCCS San Raffaele Scientific Institute, 20132 
      Milan, Italy.
FAU - Di Tomasso, Nora
AU  - Di Tomasso N
AD  - Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific 
      Institute, 20132 Milan, Italy.
FAU - Corti, Daniele
AU  - Corti D
AD  - Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific 
      Institute, 20132 Milan, Italy.
FAU - Alfieri, Ottavio
AU  - Alfieri O
AD  - Department of Cardiac Surgery, IRCCS San Raffaele Scientific Institute, 20132 
      Milan, Italy.
FAU - Gemma, Marco
AU  - Gemma M
AD  - Intensive Care Unit, Department of Neurosurgery, Fondazione IRCCS Istituto 
      Neurologico Carlo Besta, 20133 Milan, Italy.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20230726
PL  - Switzerland
TA  - Medicina (Kaunas)
JT  - Medicina (Kaunas, Lithuania)
JID - 9425208
SB  - IM
MH  - Adult
MH  - Humans
MH  - Retrospective Studies
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - Hospital Mortality
MH  - Body Mass Index
MH  - *Heart-Assist Devices
MH  - Postoperative Complications/epidemiology/etiology
PMC - PMC10456464
OTO - NOTNLM
OT  - cardiac anesthesia
OT  - mortality
OT  - postoperative pulmonary complications
COIS- The authors declare no conflict of interest.
EDAT- 2023/08/26 10:46
MHDA- 2023/08/28 06:41
PMCR- 2023/07/26
CRDT- 2023/08/26 01:20
PHST- 2023/05/06 00:00 [received]
PHST- 2023/07/15 00:00 [revised]
PHST- 2023/07/19 00:00 [accepted]
PHST- 2023/08/28 06:41 [medline]
PHST- 2023/08/26 10:46 [pubmed]
PHST- 2023/08/26 01:20 [entrez]
PHST- 2023/07/26 00:00 [pmc-release]
AID - medicina59081368 [pii]
AID - medicina-59-01368 [pii]
AID - 10.3390/medicina59081368 [doi]
PST - epublish
SO  - Medicina (Kaunas). 2023 Jul 26;59(8):1368. doi: 10.3390/medicina59081368.