Applying the 10 most frequent definitions of low cardiac output syndrome to 7,366 patients yielded highly variable intraoperative incidence estimates, ranging from 0.4% to 91% across age groups.
Cohort (n=7,366)
No
How do different definitions of low cardiac output syndrome (LCOS) affect the estimated intraoperative incidence in patients undergoing cardiac surgery?
The lack of a standardized definition for low cardiac output syndrome after cardiac surgery leads to massive variations in reported incidence rates, highlighting the need for a uniform consensus definition.
Objectives: Low cardiac output syndrome (LCOS) is a serious complication after cardiac surgery. Despite scientific interest in LCOS, there is no uniform definition used in current research and clinicians cannot properly compare different study findings. We aimed to collect the LCOS definitions used in literature and subsequently applied the definitions obtained to existing data to estimate their effect on the intraoperative LCOS incidences in adults, children and infants. Design: This is a literature review, followed by a retrospective cohort study. Setting: This is a single-institutional study from a university hospital in the Netherlands. Participants: Patients from all ages undergoing cardiac surgery with cardiopulmonary bypass between June 2011 and August 2018. Interventions: We obtained different definitions of LCOS used in the literature and applied these to data obtained from an anesthesia information management system to estimate intraoperative incidences of LCOS. We compared intraoperative incidences of LCOS in different populations based on age (infants, children and adults). Measurements and main results: The literature search identified 262 LCOS definitions, that were applied to intraoperative data from 7,366 patients. Using the 10 most frequently published LCOS definitions, the obtained incidence estimates ranged from 0.4 to 82% in infants, from 0.6 to 56% in children and from 1.5 to 91% in adults. Conclusion: There is an important variety in definitions used to describe LCOS. When applied to data obtained from clinical care, these different definitions resulted in large distribution of intraoperative LCOS incidence rates. We therefore advocate for standardization of the LCOS definition to improve clinical understanding and enable adequate comparison of outcomes and treatment effects both in daily care and in research.
Schoonen et al. (2022) conducted a cohort in Low cardiac output syndrome after cardiac surgery (n=7,366). Application of different LCOS definitions was evaluated on Intraoperative incidence of LCOS. Applying the 10 most frequent definitions of low cardiac output syndrome to 7,366 patients yielded highly variable intraoperative incidence estimates, ranging from 0.4% to 91% across age groups.