The association of complication type with mortality and prolonged stay after cardiac surgery with cardiopulmonary bypass.

Published

Journal Article

UNLABELLED: Outcome after cardiac surgery varies depending on complication type. We therefore sought to determine the association between complication type, mortality, and length of stay in a large series of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Multivariate logistic regression was used to test for differences between complication types in mortality and prolonged length of stay (>10 days) while controlling for preoperative and intraoperative risk factors. In 2609 consecutive cardiac surgical patients requiring CPB, the mortality rate was 3.6%; 36.5% had one or more complications, and 15.7% experienced an adverse outcome (death or prolonged length of stay). Multivariate logistic regression demonstrated that complication type was significantly associated with adverse outcome (P < 0.001) independent of Parsonnet score and CPB time (c-index = 0.80). The development of noncardiac complications only (Group NC) and cardiac complications with other organ involvement (Group B) significantly increased mortality and hospital and intensive care unit length of stay (P < 0.001) when compared with cardiac complications only (Group C). The incidences of adverse outcome in Groups C, NC, and B were 15%, 43%, and 67%, respectively; the mortality rates were 3%, 7%, and 20%, respectively. All these intergroup comparisons were significantly different (adjusted P < 0.05). Complications involving organs other than the heart appear to be more deleterious than cardiac complications alone, underscoring the need for strategies to reduce noncardiac complications. IMPLICATIONS: Complications, particularly when they involve organs other than just the heart, increase mortality and prolong the length of hospital stay after heart surgery, independent of a patient's preoperative risk factors and the duration of cardiopulmonary bypass. Strategies aimed at preventing damage to other organs during cardiac surgery need to be improved.

Full Text

Duke Authors

Cited Authors

  • Welsby, IJ; Bennett-Guerrero, E; Atwell, D; White, WD; Newman, MF; Smith, PK; Mythen, MG

Published Date

  • May 2002

Published In

Volume / Issue

  • 94 / 5

Start / End Page

  • 1072 - 1078

PubMed ID

  • 11973165

Pubmed Central ID

  • 11973165

Electronic International Standard Serial Number (EISSN)

  • 1526-7598

International Standard Serial Number (ISSN)

  • 0003-2999

Digital Object Identifier (DOI)

  • 10.1097/00000539-200205000-00004

Language

  • eng