Between 2005 and 2014, overall in-hospital mortality for adult cardiac surgery decreased from 2.9% to 2.3% (P<0.001) despite an increase in the mean number of patient comorbidities.
Cross-Sectional
Sí
How have comorbidity profiles and outcomes of adult cardiac surgery patients changed in the US from 2005 to 2014?
Despite an increasing comorbidity burden, in-hospital mortality and length of stay for adult cardiac surgery patients in the US have significantly decreased over time.
Tasa de eventos absoluta: 2.3% vs 2.9%
valor p: p=<.001
BACKGROUND: Comorbidity profiles of cardiac surgery patients are known to have changed over time, but modern national trends in these comorbidities and outcomes are not described. This study describes comorbidity trends over time for common adult cardiac surgery procedures. METHODS: A retrospective, cross-sectional analysis of the National Inpatient Sample was conducted for years 2005-2014. Hospitalizations with coronary artery bypass grafting (CABG), aortic valve replacement (AVR), and mitral valve repair/replacement (MVRR), as well as combined CABG/valve operations, were identified by ICD-9 procedure codes. Comorbidities were defined based on ICD-9 codes to discriminate between comorbidities and complications. Surgical volume, patient age, in-hospital mortality, and length of stay trends over time were evaluated by linear regression. RESULTS: Incidence increased for AVR, MVRR, and CABG + AVR and declined for CABG and CABG + MVRR (P < .001). The mean number of comorbidities across all surgeries increased from 1.4 to 1.9 (P < .001). Length of stay declined for AVR, CABG + AVR, and CABG + MVRR (P < .001) with an overall decline from 10.1 to 9.7 days (P = .003). In-hospital mortality decreased in all categories over time (P < .001). Overall, in-hospital mortality decreased from 2.9% to 2.3% (P < .001). CONCLUSIONS: Despite increasing comorbidity in cardiac surgery, operations are being conducted with fewer in-hospital mortalities across all types of surgery and decreasing length of stay for most types of surgery, which should inform the frequency of risk model updates and raise questions of the applicability of earlier studies in cardiac surgery to the modern population.
Mullan et al. (Vie,) realizaron un estudio transversal en cirugía cardíaca en adultos. Se evaluó la cirugía cardíaca a lo largo del tiempo (2005-2014) en comparación con la línea base histórica (2005) sobre la mortalidad general hospitalaria (p=<.001). Entre 2005 y 2014, la mortalidad global hospitalaria para la cirugía cardíaca en adultos disminuyó del 2.9% al 2.3% (P<0.001) a pesar de un aumento en el número promedio de comorbilidades de los pacientes.
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