دورية أكاديمية
[Preoperative and intraoperative risk factors affecting mortality after heart transplantation: a single-center experience].
العنوان: | [Preoperative and intraoperative risk factors affecting mortality after heart transplantation: a single-center experience]. |
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عنوان ترانسليتريتد: | Kalp nakli sonrası mortaliteyi etkileyen preoperatif ve intraoperatif risk faktörleri: Tek merkez deneyimi. |
المؤلفون: | Güngör H; Ege Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İzmir, Türkiye. drgungorhasan@yahoo.com, Ayık MF, Nalbantgil S, Ertugay S, Engin C, Yağdı T, Zoghi M, Ozbaran M |
المصدر: | Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology [Anadolu Kardiyol Derg] 2011 Mar; Vol. 11 (2), pp. 119-24. Date of Electronic Publication: 2011 Feb 02. |
نوع المنشور: | Comparative Study; Journal Article |
اللغة: | Turkish |
بيانات الدورية: | Publisher: Aves Yayincilik Country of Publication: Turkey NLM ID: 101095069 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1308-0032 (Electronic) Linking ISSN: 13028723 NLM ISO Abbreviation: Anadolu Kardiyol Derg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Aug. 2008- : Findikzade, İstanbul : Aves Yayincilik Original Publication: Cağaloğlu, İstanbul : Birikim Yayıncılık, [2001- |
مواضيع طبية MeSH: | Heart Transplantation/*mortality, Adult ; Death, Sudden, Cardiac/epidemiology ; Female ; Graft Rejection/mortality ; Humans ; Infections/mortality ; Intraoperative Period ; Logistic Models ; Male ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Ventricular Dysfunction, Right/mortality |
مستخلص: | Objective: We retrospectively analyzed case records to identify risk factors for mortality in heart transplant recipients in our center. Methods: Data of 123 patients (mean age 40.6±14 years and 97 male) transplanted from February 1998 to April 2009 were studied and analyzed. Pre- and intra-operative variables of the 73 patients who survived (Group 1, mean age 39.1±14.6, 58 male) and 50 patients who died (Group 2, mean age 42.6±12.9, 39 male) were compared. For statistical analysis Student t, Mann-Whitney U and Chi-square tests were used. Logistic regression analysis was used to determine independent risk factors for mortality and survival analysis was accomplished using Kaplan-Meier analysis. Results: Overall mortality in the entire population was 40.6% (50/123). Actuarial survival was 74%, 65%, 51% and 31% at 1, 2, 5 and 10 years respectively. Major causes of death after heart transplantation were infections (30%), right ventricular failure (18%), rejection (12%) and sudden cardiac death (12%). Total ischemic time was 176.7±63.3 minutes (range 90-410 minutes). The total cardiopulmonary by-pass (CPB) time (114.3±27.7 vs 126.9±42.1 min, p=0.05), pre-operative creatinine clearance (81.0±31.5 vs 67.2±33.0 ml/min, p=0.02), urea (45.2±18.6 vs 57.8±35.2 mg/dl, p=0.02), and creatinine (1.01±0.25 vs 1.17±0.36 mg/dl, p=0.05) were significantly different between survivors and non-survivors. Group 2 patients had higher transpulmonary gradient (TPG) (9.21±5.16 vs 12.50±8.26 mmHg, p=0.02) as compared with group 1 patients. Logistic regression analysis revealed that preoperative creatinine clearance (OR 0.989, 95% CI 0.973-1.005, p=0.044), creatinine level (OR 2.028, 95% CI 0.288-14.301, p=0.027), total CPB time (OR 1.013, 95% CI 1.000-1.027, p=0.036), and TPG (OR 1.113, 95% CI 0.992 1.249, p=0.045) were the independent predictors of mortality. Conclusion: Our data showed that TPG, total CPB time, pre-transplant renal dysfunction are pre-operative and intra-operative risk factors for mortality after heart transplantation. |
تواريخ الأحداث: | Date Created: 20110203 Date Completed: 20120105 Latest Revision: 20191210 |
رمز التحديث: | 20240628 |
DOI: | 10.5152/akd.2011.030 |
PMID: | 21285017 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1308-0032 |
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DOI: | 10.5152/akd.2011.030 |