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The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia
BACKGROUND: Among cardiac surgery patients, low preoperative left ventricular ejection fraction (LVEF) is common and has been associated with poor outcomes. The objective of this study was to assess the association between LVEF and postoperative mortality in patients undergoing open-heart surgery in...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8959716/ https://www.ncbi.nlm.nih.gov/pubmed/35356550 http://dx.doi.org/10.2147/VHRM.S350671 |
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author | Kurniawaty, Juni Setianto, Budi Yuli Supomo, Widyastuti, Yunita Boom, Cindy E |
author_facet | Kurniawaty, Juni Setianto, Budi Yuli Supomo, Widyastuti, Yunita Boom, Cindy E |
author_sort | Kurniawaty, Juni |
collection | PubMed |
description | BACKGROUND: Among cardiac surgery patients, low preoperative left ventricular ejection fraction (LVEF) is common and has been associated with poor outcomes. The objective of this study was to assess the association between LVEF and postoperative mortality in patients undergoing open-heart surgery in several hospitals in Indonesia. METHODS: We conducted a multicenter study with the retrospective design using data from patients undergoing open-heart surgery in 4 institutions in Indonesia. Data regarding LVEF and other potential risk factors were extracted from medical records and compiled in one datasheet. Statistical analyses were performed to assess if low LVEF was associated with postoperative mortality and identify other potential risk factors. RESULTS: A total of 4789 patients underwent cardiac surgery in participating centers during the study period. Of these, 189 subjects (3.9%) had poor preoperative LVEF. Poor LVEF was associated with postoperative mortality (adjusted OR 2.761, 95% CI 1.763–4.323, p < 0.001). Based on types of surgery, LVEF had a significant association with mortality only in CABG patients, while there was no such association in valve surgery and inconclusive in congenital surgery patients. Other significant independent predictors of in-hospital mortality included age more than 65 years old, non-elective surgery, the complexity of procedures, history of cardiac surgery, organ failure, CARE score ≥ 3, NYHA class ≥ III, and poor right ventricular function. CONCLUSION: Patients with low preoperative LVEF undergoing open-heart surgery had a higher risk of postoperative mortality. Cardiac surgery can be performed with acceptable mortality rates. Accurate selection of patients, risk/benefit evaluation, and planning of surgical and anesthesiological management are mandatory to improve outcomes. |
format | Online Article Text |
id | pubmed-8959716 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-89597162022-03-29 The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia Kurniawaty, Juni Setianto, Budi Yuli Supomo, Widyastuti, Yunita Boom, Cindy E Vasc Health Risk Manag Original Research BACKGROUND: Among cardiac surgery patients, low preoperative left ventricular ejection fraction (LVEF) is common and has been associated with poor outcomes. The objective of this study was to assess the association between LVEF and postoperative mortality in patients undergoing open-heart surgery in several hospitals in Indonesia. METHODS: We conducted a multicenter study with the retrospective design using data from patients undergoing open-heart surgery in 4 institutions in Indonesia. Data regarding LVEF and other potential risk factors were extracted from medical records and compiled in one datasheet. Statistical analyses were performed to assess if low LVEF was associated with postoperative mortality and identify other potential risk factors. RESULTS: A total of 4789 patients underwent cardiac surgery in participating centers during the study period. Of these, 189 subjects (3.9%) had poor preoperative LVEF. Poor LVEF was associated with postoperative mortality (adjusted OR 2.761, 95% CI 1.763–4.323, p < 0.001). Based on types of surgery, LVEF had a significant association with mortality only in CABG patients, while there was no such association in valve surgery and inconclusive in congenital surgery patients. Other significant independent predictors of in-hospital mortality included age more than 65 years old, non-elective surgery, the complexity of procedures, history of cardiac surgery, organ failure, CARE score ≥ 3, NYHA class ≥ III, and poor right ventricular function. CONCLUSION: Patients with low preoperative LVEF undergoing open-heart surgery had a higher risk of postoperative mortality. Cardiac surgery can be performed with acceptable mortality rates. Accurate selection of patients, risk/benefit evaluation, and planning of surgical and anesthesiological management are mandatory to improve outcomes. Dove 2022-03-24 /pmc/articles/PMC8959716/ /pubmed/35356550 http://dx.doi.org/10.2147/VHRM.S350671 Text en © 2022 Kurniawaty et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Kurniawaty, Juni Setianto, Budi Yuli Supomo, Widyastuti, Yunita Boom, Cindy E The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia |
title | The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia |
title_full | The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia |
title_fullStr | The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia |
title_full_unstemmed | The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia |
title_short | The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia |
title_sort | effect of low preoperative ejection fraction on mortality after cardiac surgery in indonesia |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8959716/ https://www.ncbi.nlm.nih.gov/pubmed/35356550 http://dx.doi.org/10.2147/VHRM.S350671 |
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