Key result
Redo cardiac surgery was associated with an in-hospital mortality rate of 4.6% compared to 2.2% for primary operations (p=0.11), while postoperative atrial fibrillation (OR 1.76) and EuroSCORE (OR 1.42) were identified as significant predictors of mortality.
Why the study?
Does redo cardiac surgery increase in-hospital mortality compared to primary cardiac surgery, and what are the predictors of mortality?
Cohort (n=1,367)
No
Does redo cardiac surgery increase in-hospital mortality compared to primary cardiac surgery, and what are the predictors of mortality?
Absolute Event Rate: 4.6% vs 2.2%
p-value: p=0.11
Redo cardiac surgery can be performed with similar in-hospital mortality risks as primary operations, with postoperative atrial fibrillation and EuroSCORE serving as key predictors of mortality.
Comparable in-hospital mortality supports redo cardiac surgery in selected patients; leaves open causal roles of postoperative AF and EuroSCORE pending randomized data.
PURPOSE: Redo cardiac operations represent one of the main challenges in heart surgery. The purpose of the study was to analyze the predictors of in-hospital mortality in patients undergoing reoperative cardiac surgery by a single surgical team. METHODS: A total of 1367 patients underwent cardiac surgical procedures and prospectively entered into a computerized database. Patients were divided into 2 groups based on the reoperative cardiac surgery (n = 109) and control group (n = 1258). Uni- and multivariate logistic regression analysis were performed to evaluate the possible predictors of hospital mortality. RESULTS: Mean age was 56 ± 13, and 46% were female in redo group. In-hospital mortality was 4.6 vs. 2.2%, p = 0.11. EuroSCORE (6 vs. 3; p < 0.01), cardiopulmonary bypass time (90 vs. 71 min; p < 0.01), postoperative bleeding (450 vs. 350 ml; p < 0.01), postoperative atrial fibrillation (AF) (29 vs. 16%; p < 0.01), and inotropic support (58 vs. 31%; p = 0.001) were significantly different. These variables were entered into uni- and multivariate regression analysis. Postoperative AF (OR1.76, p = 0.007) and EuroSCORE (OR 1.42, p < 0.01) were significant risk factors predicting hospital mortality. CONCLUSIONS: Reoperative cardiac surgery can be performed under similar risks as primary operations. Postoperative AF and EuroSCORE are predictors of in-hospital mortality for redo cases.
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Çölkesen et al. (2015) conducted a cohort in Cardiac surgery (n=1,367). Redo cardiac surgery vs. Primary cardiac surgery was evaluated on In-hospital mortality (p=0.11). Redo cardiac surgery was associated with an in-hospital mortality rate of 4.6% compared to 2.2% for primary operations (p=0.11), while postoperative atrial fibrillation (OR 1.76) and EuroSCORE (OR 1.42) were identified as significant predictors of mortality.
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