scholarly journals Risk stratification score to determine long‐term outcomes based on postoperative complications following cardiac surgery—Need of the hour?

2021 ◽  
Author(s):  
Siddharth Pahwa
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Complications ◽  
Risk Stratification ◽  
Long Term Outcomes ◽  
Risk Stratification Score

scholarly journals Risk stratification score to determine long-term outcomes based on post-operative complications following cardiac surgery -- need of the hour?

2021 ◽  
Author(s):  
Siddharth Pahwa
Keyword(s):  
Risk Stratification ◽  
Risk Model ◽  
Cardiac Surgical Procedures ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Risk Algorithm ◽  
Operative Complications ◽  
Risk Stratification Score ◽  
Post Operative Complications

Risk models were developed to provide clinicians and hospitals with a tool to evaluate risk-adjusted outcomes and to guide quality improvement. The Society of Thoracic Surgeons (STS) Predicted Risk of Mortality (PROM) is the most commonly used risk algorithm, others being the EuroSCORE logistic and additive algorithm and the Ambler Risk Score. These models utilize pre-operative patient characteristics to predict operative risk and early outcomes. Although a great deal of effort has gone into models to predict short-term patient outcomes after common cardiac operations, there has been relatively little effort to develop a statistical algorithm to predict long-term outcomes. Moreover, no risk model takes into account early post-operative complications to construct an algorithm to predict long-term outcomes. The formulation of a risk stratification score based on post-operative complications following common cardiac surgical procedures may be used to estimate the likelihood of long-term survival for individual complications, as well as various permutations and combinations of complications. This may have profound implications in devising strategies to prevent the most devastating combination of complications. Also, this may assist in informing patients and families of the predicted survival after a particular complication or a combination of complications. As Dokollari et all pointed out, there is impetus towards the direction of formulating a risk stratification score, and this may indeed be the need of the hour.

Long-Term Outcomes of Reoperation for Bleeding After Cardiac Surgery

2020 ◽  
Author(s):  
James A. Brown ◽  
Arman Kilic ◽  
Edgar Aranda-Michel ◽  
Forozan Navid ◽  
Derek Serna-Gallegos ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Long Term Outcomes

Risk scoring by CHADS2 and CHA2DS2-VASc as predictors for long-term outcomes after surgical ablation for atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Lauritzen ◽  
H.J Vodstrup ◽  
T.D Christensen ◽  
M Onat ◽  
R Christensen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Isolation Procedure ◽  
Survival Times ◽  
Long Term Outcomes ◽  
Surgical Ablation ◽  
Follow Up Study ◽  
Risk Scoring

Abstract Background Following catheter ablation for atrial fibrillation (AF), CHADS2 and CHA2DS2-VASc have utility in predicting long-term outcomes. However, it is currently unknown if the same holds for patients undergoing surgical ablation. Purpose To determine whether CHADS2 and CHA2DS2-VASc predict long-term outcomes after surgical ablation in concomitance with other cardiac surgery. Methods In this prospective, follow-up study, we included patients who underwent biatrial ablation - or pulmonary vein isolation procedure concomitantly with other cardiac surgery between 2004 and 2018. CHADS2 and CHA2DS2-VASc scores were assessed prior to surgery and categorized in groups as 0–1, 2–4 or ≥5. Outcomes were death, AF, and AF-related death. Follow-up was ended in April 2019. Results A total of 587 patients with a mean age of 68.7±0.4 years were included. Both CHADS2 and CHA2DS2-VASc scores were predictors of survival p=0.005 and p<0.001, respectively (Figure). For CHADS2, mean survival times were 5.9±3.7 years for scores 0–1, 5.0±3.0 years for scores 2–4 and 4.3±2.6 years for scores ≥5. For CHA2DS2-VASc mean survival times were 7.3±4.0 years for scores 0–1, 5.6±2.9 years for scores 2–4 and 4.8±2.1 years for scores ≥5. The incidence of death was 20.1% for CHADS2 0–1, 24.8% for CHADS2 2–4, and 35.3% for CHADS2 ≥5, p=0.186. The incidence of AF was 50.2% for CHADS2 0–1, 47.9% for CHADS2 2–4, and 76.5% for CHADS2 ≥5, p=0.073. The incidence of AF related death was 13.0% for CHADS2 0–1, 16.8% for CHADS2 2–4, and 35.3% for CHADS2 ≥5, p=0.031. The incidence of death was 16.8% for CHA2DS2-VASc 0–1, 26.2% for CHA2DS2-VASc 2–4, and 45.0% for CHA2DS2-VASc ≥5, p=0.001. The incidence of AF was 49.6% for CHA2DS2-VASc 0–1, 52.5% for CHA2DS2-VASc 2–4, and 72.5% for CHA2DS2-VASc ≥5, p=0.035. The incidence of AF related death was 12.2% for CHA2DS2-VASc 0–1, 16.0% for CHA2DS2-VASc 2–4, and 42.5% for CHA2DS2-VASc ≥5, p<0.001. Conclusion Both CHADS2 and CHA2DS2-VASc scores predict long-term outcomes after surgical ablation for AF. However, CHA2DS2-VASc was superior in predicting death, AF, and AF-related death. Survival curves Funding Acknowledgement Type of funding source: None

scholarly journals COVID-19 related mortality in post-operative cardiac surgical patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Azhar Hussain ◽  
Amina Khalil ◽  
Priyanka Kolvekar ◽  
Prity Gupta ◽  
Shyamsunder Kolvekar
Keyword(s):  
Cardiac Surgery ◽  
Long Term Outcomes ◽  
Case Presentation ◽  
Elective Cardiac Surgery ◽  
The United Kingdom ◽  
Global Pandemic ◽  
Cardiac Operations ◽  
Related Mortality

Abstract Background COVID-19 has caused a global pandemic of unprecedented proportions. Elective cardiac surgery has been universally postponed with only urgent and emergency cardiac operations being performed. The National Health Service in the United Kingdom introduced national measures to conserve intensive care beds and significantly limit elective activity shortly after lockdown. Case presentation We report two cases of early post-operative mortality secondary to COVID-19 infection immediately prior to the implementation of these widespread measures. Conclusion The role of cardiac surgery in the presence of COVID-19 is still very unpredictable and further studies on both short term and long term outcomes are warranted.

Intermediate and Long-Term Outcomes Following Robotic Cardiac Surgery in an Australian Cohort

2007 ◽  
Vol 16 ◽  
pp. S99 ◽  
Author(s):  
Melynda Turner ◽  
Mari Botti ◽  
Rosemary Watts ◽  
Robyn English ◽  
Christine Balfour
Keyword(s):  
Cardiac Surgery ◽  
Long Term Outcomes ◽  
Robotic Cardiac Surgery ◽  
Australian Cohort

scholarly journals LONG-TERM OUTCOMES OF PATIENTS WITH RADIATION HEART DISEASE UNDERGOING CARDIAC SURGERY: CLINICAL AND ECHOCARDIOGRAPHIC PREDICTORS

2011 ◽  
Vol 57 (14) ◽  
pp. E1401
Author(s):  
Willis Wu ◽  
Nicholas Smedira ◽  
Thomas Marwick ◽  
Donald Hammer ◽  
Bruce W. Lytle ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Long Term Outcomes

Pneumonectomy for Treatment of Destroyed Lung: A Retrospective Study of 137 Patients

2016 ◽  
Vol 65 (07) ◽  
pp. 528-534 ◽  
Author(s):  
Yuping Li ◽  
Gening Jiang ◽  
Chang Chen ◽  
Xuefei Hu
Keyword(s):  
Risk Factor ◽  
Postoperative Complications ◽  
Operative Technique ◽  
Independent Risk Factor ◽  
Multivariate Analyses ◽  
Bronchopleural Fistula ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Destroyed Lung

Objectives Whether pneumonectomy is needed for the treatment of destroyed lungs is still controversial and unresolved in the clinic. Pneumonectomy is destructive and is associated with a significant incidence of postoperative complications. The purpose of this study is to analyze the operative techniques, postoperative morbidity, mortality, and long-term outcomes of patients with destroyed lungs who underwent pneumonectomy. Patients and Methods We retrospectively analyzed 137 patients with destroyed lungs who underwent pneumonectomy. The data were queried for the details of operative technique, development of perioperative complications, mortality, and long-term survival. Univariate and multivariate analyses were performed to investigate the risk factors of pneumonectomy among the patients. Results A total of 77 male and 60 female patients were reviewed. The youngest patient was 18 years, and the oldest was 75 years, with a mean age of 40.1 years. Postoperative complications were observed in 25 patients (18.2%). The rate of bronchopleural fistula (BPF) was 5.1% (7/137). Two perioperative deaths (1.5%) were noted. Univariate and multivariate analyses indicated the blood loss (hazard ratio [HR], 5.32; 95% confidence interval [CI], 1.27–18.50; p = 0.021) was the independent risk factor of postoperative complications, and the type of the disease (HR, 4.50; 95% CI, 1.19–9.69; p = 0.034) was the independent risk factor of the BPF, for the patients with destroyed lung after pneumonectomy. Conclusion Pneumonectomy for destroyed lung is a high risk for postoperative complications. Our findings suggested that pneumonectomy in destroyed lung was satisfactory with strict surgical indications, adequate preoperative preparation, and careful operative technique, and the long-term outcomes can be especially satisfactory. Pneumonectomy for destroyed lung is still a treatment option.

scholarly journals The impact of major postoperative complications on long-term outcomes following curative resection of colon cancer

2018 ◽  
Vol 52 ◽  
pp. 303-308 ◽  
Author(s):  
Javier A. Cienfuegos ◽  
Jorge Baixauli ◽  
Carmen Beorlegui ◽  
Patricia Martínez Ortega ◽  
Lucía Granero ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Postoperative Complications ◽  
Curative Resection ◽  
Long Term Outcomes ◽  
The Impact

Prognosis research in people with coronary heart disease

2019 ◽  
pp. 258-267
Author(s):  
Adam Timmis ◽  
Pablo Perel ◽  
Peter Croft
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Risk Stratification ◽  
Secondary Prevention ◽  
Treatment Decisions ◽  
Long Term Outcomes ◽  
Prognosis Research

Coronary heart disease (CHD) outcomes have improved in recent decades because of better treatment, improved investigations, and better secondary prevention. The results of prognosis research have contributed to the development and evaluation of these new components of healthcare for CHD, but have also critically questioned traditional classifications of CHD, emphasized the importance of long-term outcomes in judging the success of healthcare in CHD patients, and highlighted the potential of risk stratification to guide better treatment decisions for individual patients with CHD. This chapter uses example studies to illustrate this story.

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