Key result
Advanced NYHA class and creatinine >1.5 mg/dl predict higher hospital mortality after valvular reoperation.
Why the study?
Risk factors for hospital mortality in patients undergoing valvular reoperations for prosthetic valve dysfunction were not well defined.
What are the independent predictors of hospital mortality in patients undergoing valvular reoperations for prosthetic valve dysfunction?
Observational (n=146)
No
What are the independent predictors of hospital mortality in patients undergoing valvular reoperations for prosthetic valve dysfunction?
Advanced NYHA functional class and elevated creatinine (>1.5 mg/dl) are independent predictors of hospital mortality in patients undergoing reoperation for prosthetic valve dysfunction.
May inform risk stratification for prosthetic valve reoperations; leaves open whether targeting these factors improves outcomes.
OBJECTIVES: The purpose of the study was to analyze risk factors for hospital mortality in patients undergoing valvular reoperations for prosthetic valve dysfunction. METHODS: We performed a prospective analysis of 146 patients who underwent valvular reoperations for prosthetic valve dysfunction between July 1995 and June 1999 at the Heart Institute of the University of São Paulo Medical School. Multivariate statistical analysis with logistic regression was used to analyze preoperative and intraoperative variables to determine risk factors for hospital mortality. RESULTS: The overall hospital mortality was 10.9% (16 patients). Univariate analysis showed that the following variables were associated with higher mortality rates: advanced New York Heart Association (NYHA) functional class, increased creatinine level, prolonged extracorporeal circulation time and treatment of annular abscess. Logistic multivariate analysis identified advanced NYHA functional class and a creatinine level higher than 1.5 mg/dl as independent predictors of hospital mortality. CONCLUSIONS: Advanced NYHA functional class and higher creatinine levels were independent predictors of hospital mortality in patients submitted for valvular reoperations for prosthetic valve dysfunction.
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Pomerantzeff et al. (2002) conducted an observational in Prosthetic valve dysfunction requiring reoperation (n=146). Advanced NYHA functional class and elevated creatinine vs. Lower NYHA functional class and normal creatinine was evaluated on Hospital mortality. Advanced NYHA functional class and creatinine levels >1.5 mg/dl were independent predictors of hospital mortality (overall rate 10.9%) in patients undergoing valvular reoperations.
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