دورية أكاديمية
أعرض في EDS

Trends in the Utilization of Multiorgan Support Among Adults Undergoing High-risk Cardiac Surgery in the United States.

التفاصيل البيبلوغرافية
العنوان: Trends in the Utilization of Multiorgan Support Among Adults Undergoing High-risk Cardiac Surgery in the United States.
المؤلفون: Cobert J; Anesthesia Service, San Francisco VA Health Care System, San Francisco, CA; Department of Anesthesiology, University of California San Francisco, San Francisco, CA; Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC. Electronic address: Julien.Cobert@ucsf.edu., Frere Z; Yale University. Department of Statistics. New Haven, CT., Wongsripuemtet P; Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand., Ohnuma T; Department of Anesthesiology, University of California San Francisco, San Francisco, CA; Department of Anesthesiology, Duke University, Durham, NC., Krishnamoorthy V; Department of Anesthesiology, University of California San Francisco, San Francisco, CA; Department of Anesthesiology, Duke University, Durham, NC; Department of Population Health Sciences, Duke University, Durham, NC., Fuller M; Department of Anesthesiology, University of California San Francisco, San Francisco, CA; Department of Anesthesiology, Duke University, Durham, NC., Chapman AC; Palliative Medicine, Department of Internal Medicine, University of California San Francisco, San Francisco, CA; Department of Surgery, University of California San Francisco, San Francisco, CA., Yaport M; Department of Anesthesiology, University of California San Francisco, San Francisco, CA; Department of Anesthesiology, Duke University, Durham, NC., Ghadimi K; Department of Anesthesiology, University of California San Francisco, San Francisco, CA; Department of Anesthesiology, Duke University, Durham, NC., Bartz R; Department of Anesthesiology, Brigham and Women's Hospital, Harvard University. Boston, MA., Raghunathan K; Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Department of Anesthesiology, Duke University, Durham, NC; Department of Population Health Sciences, Duke University, Durham, NC; Anesthesia Service, Durham VA Healthcare System. Durham, NC.
المصدر: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2024 Sep; Vol. 38 (9), pp. 1987-1995. Date of Electronic Publication: 2024 Apr 27.
نوع المنشور: Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 9110208 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8422 (Electronic) Linking ISSN: 10530770 NLM ISO Abbreviation: J Cardiothorac Vasc Anesth Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : W.B. Saunders, c1991-
مواضيع طبية MeSH: Cardiac Surgical Procedures*/trends , Cardiac Surgical Procedures*/mortality , Multiple Organ Failure*/epidemiology , Multiple Organ Failure*/mortality, Humans ; Male ; Retrospective Studies ; Female ; United States/epidemiology ; Middle Aged ; Aged ; Adult ; Postoperative Complications/epidemiology ; Hospital Mortality/trends ; Risk Factors ; Cohort Studies
مستخلص: Objectives: To examine trends in the prevalence of multiorgan dysfunction (MODS), utilization of multi-organ support (MOS), and mortality among patients undergoing cardiac surgery with MODS who received MOS in the United States.
Design: Retrospective cohort study.
Setting: 183 hospitals in the Premier Healthcare Database.
Participants: Adults ≥18 years old undergoing high-risk elective or non-elective cardiac surgery.
Interventions: none.
Measurements and Main Results: The exposure was time (consecutive calendar quarters) January 2008 and June 2018. We analyzed hospital data using day-stamped hospital billing codes and diagnosis and procedure codes to assess MODS prevalence, MOS utilization, and mortality. Among 129,102 elective and 136,190 non-elective high-risk cardiac surgical cases across 183 hospitals, 10,001 (7.7%) and 21,556 (15.8%) of patients developed MODS, respectively. Among patients who experienced MODS, 2,181 (22%) of elective and 5,425 (25%) of non-elective cardiac surgical cases utilized MOS. From 2008-2018, MODS increased in both high-risk elective and non-elective cardiac surgical cases. Similarly, MOS increased in both high-risk elective and non-elective cardiac surgical cases. As a component of MOS, mechanical circulatory support (MCS) increased over time. Over the study period, risk-adjusted mortality, in patients who developed MODS receiving MOS, increased in high-risk non-elective cardiac surgery and decreased in high-risk elective cardiac surgery, despite increasing MODS prevalence and MOS utilization (p<0.001).
Conclusions: Among patients undergoing high-risk cardiac surgery in the United States, MODS prevalence and MOS utilization (including MCS) increased over time. Risk-adjusted mortality trends differed in elective and non-elective cardiac surgery. Further research is necessary to optimize outcomes among patients undergoing high-risk cardiac surgery.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: JC reports consulting fees from Teleflex, but there are no other conflicts of interest to report.
(Published by Elsevier Inc.)
فهرسة مساهمة: Keywords: adult cardiac surgery; mechanical circulatory support; mortality; multiorgan failure
تواريخ الأحداث: Date Created: 20240626 Date Completed: 20240822 Latest Revision: 20240822
رمز التحديث: 20240823
DOI: 10.1053/j.jvca.2024.04.038
PMID: 38926003
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-8422
DOI:10.1053/j.jvca.2024.04.038