TY - JOUR
T1 - Cardiopulmonary Bypass Duration Is an Independent Predictor of Morbidity and Mortality After Cardiac Surgery
AU - Salis, Stefano
AU - Mazzanti, Valeria V.
AU - Merli, Guido
AU - Salvi, Luca
AU - Tedesco, Calogero C.
AU - Veglia, Fabrizio
AU - Sisillo, Erminio
PY - 2008/12
Y1 - 2008/12
N2 - Objective: The aim of this study was to determine if there is a direct relationship between the duration of cardiopulmonary bypass (CPB time [CPBT]) and postoperative morbidity and mortality in patients undergoing cardiac surgery. Design: Retrospective study. Setting: Cardiac surgery unit, university hospital. Participants: Five thousand six patients, New York Heart Association classes 1 through 4, who underwent cardiac surgery between January 2002 and March 2008. Interventions: All patients were subjected to CPB. Measurements and Main Results: The mean CPBT was 115 minutes (median 106). One hundred thirty-one patients (2.6%) died during the same hospitalization. The postoperative median blood loss was 600 mL. Reoperations for bleeding occurred in 193 patients (3.9%), and 1,001 patients received 3 or more units of red blood cells. There were 108 patients (2.2%) with neurologic sequelae, 391 patients (7.8%) with renal complications, 37 patients (0.7%) with abdominal complications, and 184 patients (3.7%) with respiratory complications. Seventy-two patients (1.4%) had an infective complication, and 80 patients (1.6%) had a postoperative multiorgan failure. The multivariate analysis confirmed the role of CPBT, considered in 30-minute increments, as an independent risk factor for postoperative death (odds ratio [OR] = 1.57, p <0.0001), pulmonary (OR = 1.17, p <0.0001), renal (OR 1.31, p <0.0001), and neurologic complications (OR = 1.28, p <0.0001), multiorgan failure (OR = 1.21, p <0.0001), reoperation for bleeding (OR = 1.1, p = 0.0165), and multiple blood transfusions (OR = 1.58, p <0.0001). Conclusions: Prolonged CPB duration independently predicts postoperative morbidity and mortality after cardiac surgery.
AB - Objective: The aim of this study was to determine if there is a direct relationship between the duration of cardiopulmonary bypass (CPB time [CPBT]) and postoperative morbidity and mortality in patients undergoing cardiac surgery. Design: Retrospective study. Setting: Cardiac surgery unit, university hospital. Participants: Five thousand six patients, New York Heart Association classes 1 through 4, who underwent cardiac surgery between January 2002 and March 2008. Interventions: All patients were subjected to CPB. Measurements and Main Results: The mean CPBT was 115 minutes (median 106). One hundred thirty-one patients (2.6%) died during the same hospitalization. The postoperative median blood loss was 600 mL. Reoperations for bleeding occurred in 193 patients (3.9%), and 1,001 patients received 3 or more units of red blood cells. There were 108 patients (2.2%) with neurologic sequelae, 391 patients (7.8%) with renal complications, 37 patients (0.7%) with abdominal complications, and 184 patients (3.7%) with respiratory complications. Seventy-two patients (1.4%) had an infective complication, and 80 patients (1.6%) had a postoperative multiorgan failure. The multivariate analysis confirmed the role of CPBT, considered in 30-minute increments, as an independent risk factor for postoperative death (odds ratio [OR] = 1.57, p <0.0001), pulmonary (OR = 1.17, p <0.0001), renal (OR 1.31, p <0.0001), and neurologic complications (OR = 1.28, p <0.0001), multiorgan failure (OR = 1.21, p <0.0001), reoperation for bleeding (OR = 1.1, p = 0.0165), and multiple blood transfusions (OR = 1.58, p <0.0001). Conclusions: Prolonged CPB duration independently predicts postoperative morbidity and mortality after cardiac surgery.
KW - cardiac surgery
KW - cardiopulmonary bypass
KW - postoperative complications
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U2 - 10.1053/j.jvca.2008.08.004
DO - 10.1053/j.jvca.2008.08.004
M3 - Article
C2 - 18948034
AN - SCOPUS:56349156090
VL - 22
SP - 814
EP - 822
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 6
ER -