Cardiopulmonary Bypass Duration Is an Independent Predictor of Morbidity and Mortality After Cardiac Surgery

Stefano Salis, Valeria V. Mazzanti, Guido Merli, Luca Salvi, Calogero C. Tedesco, Fabrizio Veglia, Erminio Sisillo

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)814-822
Number of pages9
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume22
Issue number6
DOIs
Publication statusPublished - Dec 2008

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Cardiopulmonary Bypass
Thoracic Surgery
Morbidity
Mortality
Odds Ratio
Reoperation
Nervous System
Hemorrhage
Kidney
Postoperative Hemorrhage
Blood Transfusion
Hospitalization
Multivariate Analysis
Retrospective Studies
Erythrocytes
Lung

Keywords

  • cardiac surgery
  • cardiopulmonary bypass
  • postoperative complications

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

Cite this

Cardiopulmonary Bypass Duration Is an Independent Predictor of Morbidity and Mortality After Cardiac Surgery. / Salis, Stefano; Mazzanti, Valeria V.; Merli, Guido; Salvi, Luca; Tedesco, Calogero C.; Veglia, Fabrizio; Sisillo, Erminio.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 22, No. 6, 12.2008, p. 814-822.

Research output: Contribution to journalArticle

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abstract = "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.",
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AU - Salis, Stefano

AU - Mazzanti, Valeria V.

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AU - Salvi, Luca

AU - Tedesco, Calogero C.

AU - Veglia, Fabrizio

AU - Sisillo, Erminio

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KW - cardiac surgery

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KW - postoperative complications

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