دورية أكاديمية
[Prospective risk analysis in patients submitted to myocardial revascularization surgery].
| العنوان: | [Prospective risk analysis in patients submitted to myocardial revascularization surgery]. |
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| عنوان ترانسليتريتد: | Análise prospectiva de risco em pacientes submetidos à cirurgia de revascularização miocárdica. |
| المؤلفون: | Bianco AC; Instituto Dante Pazzanese de Cardiologia, Rua Pelotas 323/113, 04012-001 São Paulo, SP. mugayarb@terra.com.br, Timerman A, Paes AT, Gun C, Ramos RF, Freire RB, Vela CN, Fagundes Junior AA, Martins LC, Piegas LS |
| المصدر: | Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2005 Oct; Vol. 85 (4), pp. 254-61. Date of Electronic Publication: 2005 Nov 07. |
| نوع المنشور: | English Abstract; Journal Article |
| اللغة: | Portuguese |
| بيانات الدورية: | Publisher: Sociedad Brasileira De Cardiologia Country of Publication: Brazil NLM ID: 0421031 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0066-782X (Print) Linking ISSN: 0066782X NLM ISO Abbreviation: Arq Bras Cardiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Sao Paulo : Sociedad Brasileira De Cardiologia |
| مواضيع طبية MeSH: | Myocardial Revascularization/*mortality, Adult ; Aged ; Aged, 80 and over ; Brazil/epidemiology ; Epidemiologic Methods ; Female ; Humans ; Male ; Middle Aged |
| مستخلص: | Objective: To perform a stratified risk analysis in Myocardial Revascularization Surgery (MRS). Methods: 814 patients were prospectively studied by applying two prognostic indexes (PI): Parsonnet and Modified Higgins. The Higgins PI was modified by substituting the variable "cardiac index value" by "low cardiac output syndrome" at the Intensive Care Unit (ICU) admission. The discriminatory capacity for morbimortality of both indexes was analyzed by ROC (receiver operating characteristic) curve. Logistic reaction identified the associated factors, independently from the events. Results: Mortality and morbidity rates were 5.9% and 35.5%, respectively. The Modified Higgins PI, which analyzes pre- and intra-operative and physiological variables at the ICU admission showed areas under the ROC curve of 77% for mortality and 67% for morbidity. The Parsonnet PI, which only analyzes pre-operative variables, showed areas of 62.2% and 62.4%, respectively. Twelve variables were characterized as independent prognostic factors: age, diabetes mellitus, low body surface, creatinine levels (>1.5 mg/dL), hypoalbuminemia, non-elective surgery, prolonged time of extracorporeal circulation (ECC), necessity of post-ECC intra-aortic balloon, low cardiac output syndrome at the ICU admission, elevated cardiac frequency, decrease in serum bicarbonate concentrations and increase of the alveolar-arterial oxygen gradient within this period. Conclusion: The Modified Higgins PI showed to be superior to the Parsonnet PI at the surgical risk stratification, showing the importance of the analysis of intraoperative events and physiological variables at the patient's ICU admission, when prognostic definition is achieved. |
| تواريخ الأحداث: | Date Created: 20051112 Date Completed: 20070822 Latest Revision: 20190606 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1590/s0066-782x2005001700005 |
| PMID: | 16283031 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 0066-782X |
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| DOI: | 10.1590/s0066-782x2005001700005 |