scholarly journals Incidence, Indications, and Risk Factors of Reopening After Cardiac Surgery in Tertiary Cardiac Center, Sudan: Retrospective Observational Study

2020 ◽  
pp. 1-7
Author(s):  
Fatimah Azhari Gasmalla Gadeltayeb ◽  
◽  
Elfatih M Malik ◽  
Elamin E Elnur ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Observational Study ◽  
Nyha Class ◽  
Postoperative Bleeding ◽  
Retrospective Observational Study ◽  
Increased Risk ◽  
Cardiac Center

Background: Chest re-opening after cardiac surgery is a surgical approach that is performed for diagnosis and management of some postoperative complications. The rate of reopening varies from 2% to 6% of patients undergoing cardiac surgery. The most frequent indication for reopening, followed by cardiac tamponade, cardiac arrest and redo surgery. Several risk factors have been associated with reopening such as, age, sex, BMI, NYHA class, diabetes mellitus, cardiopulmonary bypass and aortic cross clamp time. The aim of this study is to determine the incidence, indications, and risk factors of reopening after cardiac surgery. Methods: In this retrospective observational study, a total of consecutive 638 patients who underwent cardiac surgery in Ahmed Gasim cardiac center in 2017 were included. Results: The incidence of reopening was found to be 61 per 1000 in all age groups, 90 per 1000 in adults, and 34 per 1000 in paediatrics. Out of 39 reopening cases, Bleeding was found to be the most frequent indication of reopening. multivariate analysis by logistic regression revealed that, having NYHA class II odd ratio OR = 24.767 (95% confidence interval CI = 1.048 – 585.3), past cardiac surgery OR = 13.9(95% CI = 1.013 – 193.3), having diabetes mellitus OR = 4.885 (95% CI = 1.251 –19.056 ),longer cardiopulmonary bypass time OR = 1.012 (95% CI = 1.00 – 1.024), preoperative aspirin OR = 3.528 (95% CI = 1.062 – 11.720), and warfarin OR = 12.790 (95% CI = 1.594 – 102.3) all are associated with increased risk of reopening after cardiac surgery. Conclusion : Incidence of reopening in Sudan was relatively higher than the international records. Reopening was mostly performed for postoperative bleeding management. Cardiac failure assessed by NYHA classification, previous cardiac surgery, diabetes mellitus, anti thrombotic therapy and longer bypass time were associated with increased risk of reopening

scholarly journals Clinical, biochemical and genetic risk factors for 30-day and 5-year mortality in 518 adult patients subjected to cardiopulmonary bypass during cardiac surgery - the INFLACOR study.

2018 ◽  
Vol 65 (2) ◽  
pp. 241-250 ◽  
Author(s):  
Maciej Michał Kowalik ◽  
Romuald Lango ◽  
Piotr Siondalski ◽  
Magdalena Chmara ◽  
Maciej Brzeziński ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Genetic Association ◽  
Biochemical Parameters ◽  
Cox Regression ◽  
Association Studies ◽  
Nyha Class ◽  
Genetic Association Studies ◽  
Chronic Obstructive

There is increasing evidence that genetic variability influence patients’ early morbidity after cardiac surgery performed using cardiopulmonary bypass (CPB). The use of mortality as an outcome measure in cardiac surgical genetic association studies is rare. We publish the 30-day and 5-year survival analyses with focus on pre-, intra-, postoperative variables, biochemical parameters, and genetic variants in the INFLACOR (INFlAmmation in Cardiac OpeRations) cohort.In a series of prospectively recruited 518 adult Polish Caucasians who underwent cardiac surgery in which CPB was used, the clinical data, biochemical parameters, IL-6, soluble ICAM-1, TNFa, soluble E-selectin, and 10 single nucleotide polymorphisms were evaluated for their associations with 30-day and 5-year mortality.The 30-day mortality was associated with: pre-operative prothrombin international normalized ratio, intra-operative blood lactate, postoperative serum creatine phosphokinase, and acute kidney injury requiring renal replacement therapy (AKI-RRT) in logistic regression. Factors that determined the 5-year survival included: pre-operative NYHA class, history of peripheral artery disease and severe chronic obstructive pulmonary disease, intra-operative blood transfusion; and postoperative peripheral hypothermia, myocardial infarction, infection, and AKI-RRT in Cox regression. The serum levels of IL-6 and ICAM-1 measured three hours after operation were associated with 30-day and 5-year mortality, respectively. The ICAM1 rs5498 was associated with 30-day and 5-year survival with borderline significance.Different risk factors determined the early (30-day) and late (5-year) survival after adult cardiac surgery in which cardiopulmonary bypass was used. Future genetic association studies in cardiac surgical patients should adjust for the identified chronic and acute postoperative risk factors.

scholarly journals Risk factors for the development of significant postoperative bleeding after pediatric cardiac surgery with cardiopulmonary bypass: A nested case-control study

2017 ◽  
Vol 6 (3) ◽  
pp. 5
Author(s):  
JuanCarlos Núñez-Enríquez ◽  
IsabelZnaya Ramírez-Flores ◽  
Maribel Ibarra-Sarlat ◽  
Vivian Neme-Bechara ◽  
Alejandro Herrera-Landero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Case Control Study ◽  
Postoperative Bleeding ◽  
Case Control ◽  
Pediatric Cardiac Surgery ◽  
Nested Case Control ◽  
Control Study

scholarly journals ECG CHANGES IN PATIENTS WITH COVID-19 – A RETROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL IN CHENNAI

2021 ◽  
pp. 5-7
Author(s):  
A .Shaik Sulaiman Meeran ◽  
T. Balaji ◽  
P. Raja ◽  
Kiran Chandramohan
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Virus Disease ◽  
Tertiary Care ◽  
P Wave ◽  
Retrospective Observational Study ◽  
Care Hospital ◽  
Icu Admission ◽  
Corona Virus ◽  
Increased Risk

Background:A global outbreak of corona virus disease, caused by severe respiratory corona virus 2, has emerged since December 2019. However electrocardiographic manifestations of patients with COVID-19 have not been fully described. We aim to investigate ECG characteristics in COVID-19 patients and risk factors of ICU admission Methods:This retrospective observational study included the patients with COVID-19 at the Government Kilpauk Medical College, Chennai between June 1st and 31st, 2020. Demographic, clinical and ECG characteristics were collected and comparison were made between ICU and non ICU admission groups. Logistic regression was used to identify risk factors of ICU admission Results:Among the 159 patients included ST-T abnormalities were the most common ECG feature followed by arrhythmias. Compared with non ICU group, the ICU group showed higher heart rate and P wave duration and was more frequently associated with CVD, ST-T abnormalities, arrythmias, QTc prolongation and pathological Q waves. ST-T abnormalities and history of CVD were associated with increased risk of ICU admission Conclusion:COVID-19 is frequently related to cardiovascular manifestations including ECG abnormalities and cardiovascular comorbidities. ST-T abnormalities and CVD at admission were associated with increased odds of ICU admission

scholarly journals Risk factors of sepsis after open congenital cardiac surgery in infants: a pilot study

2016 ◽  
Vol 25 (3) ◽  
pp. 182-9
Author(s):  
Dicky Fakhri ◽  
Pribadi W. Busro ◽  
Budi Rahmat ◽  
Salomo Purba ◽  
Aryo A.P. Mukti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Nutritional Status ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Laboratory Data ◽  
Mortality And Morbidity ◽  
Congenital Cardiac Surgery ◽  
Increased Risk

Background: Postsurgical sepsis is one of the main causes of the high mortality and morbidity after open congenital heart surgery in infants.  This study aimed to evaluate the role of cardiopulmonary bypass duration, thymectomy, surgical complexity, and nutritional status on postsurgical sepsis after open congenital cardiac surgery in infants.Methods: A total of 40 patients <1 year of age with congenital heart disease, Aristotle Basic Score (ABS) ≥6 were followed for clinical and laboratory data before and after surgery until the occurrence of signs or symptoms of sepsis or until a maximum of 7 days after surgery. Bivariate analyses were performed. Variables with p≤0.200 were then included for logistic regression.Results: Duration of cardiopulmonary bypass ≥90 minutes was associated with 5.538 increased risk of postsurgical sepsis in comparison to those ≤90 minutes (80% vs 25%, RR=5.538, p=0.006). No association was observed between the incidence of postsurgical sepsis with poor nutritional status (86% vs 84%, RR=1.059, p=1.000), thymectomy (and 50% vs 76%, RR=0.481, p=0.157), and Aristotle Basic Score (p=0.870).Conclusion: Cardiopulmonary bypass time influences the incidence of sepsis infants undergoing open congenital cardiac surgery. Further studies are needed to elaborate a number of risk factors associated with the incidence of sepsis in this population.

scholarly journals Association of Plasma Fibrinogen and Thromboelastography With Blood Loss in Complex Cardiac Surgery

2021 ◽  
Vol 27 ◽  
pp. 107602962110165
Author(s):  
Eline A. Vlot ◽  
Eric P.A. van Dongen ◽  
Laura M. Willemsen ◽  
Jur M. ten Berg ◽  
Christian M. Hackeng ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Blood Loss ◽  
Clinical Decision Making ◽  
Postoperative Bleeding ◽  
Clinical Decision ◽  
Fibrinogen Concentration ◽  
Coagulation Parameters ◽  
Increased Risk

Postoperative coagulopathic bleeding is common in cardiac surgery and is associated with increased morbidity and mortality. Ideally, real-time information on in-vivo coagulation should be available. However, up to now it is unclear which perioperative coagulation parameters can be used best to accurately identify patients at increased risk of bleeding. The present study analyzed the associations of perioperative fibrinogen concentrations and whole blood viscoelastic tests with postoperative bleeding in 89 patients undergoing combined cardiac surgery procedures. Postoperative bleeding was recorded until 24 hours after surgery. Regression analyses were performed to establish associations between blood loss and coagulation parameters after cardiopulmonary bypass including a prediction model with known confounding factors for bleeding. Coagulation tests show large changes over the perioperative course with the strongest coagulopathic deviations from baseline after cardiopulmonary bypass. After adjustment for multiple confounders, viscoelastic clot strength instead of fibrinogen concentration showed a similar performance for 24 hour blood loss and a better performance for 6 hour blood loss. This makes intraoperative viscoelastic testing a useful tool to strengthen early clinical decision-making with the potential to reduce perioperative blood transfusions.

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