[Mortality from postoperative complications (failure to rescue) after cardiac surgery in a university hospital].

Autor:	Riera M; Unidad de Cuidados Intensivos, Hospital Universitari Son Espases, Palma de Mallorca, Islas Baleares, España. Electronic address: maria.riera@ssib.es., Amézaga R; Unidad de Cuidados Intensivos, Hospital Universitari Son Espases, Palma de Mallorca, Islas Baleares, España., Molina M; Unidad de Cuidados Intensivos, Hospital Universitari Son Espases, Palma de Mallorca, Islas Baleares, España., Campillo-Artero C; Servei de Salut de les Illes Balears, Palma de Mallorca, CRES-UPF, Barcelona, España., Sáez de Ibarra JI; Servicio de Cirugía Cardiaca, Hospital Universitari Son Espases, Palma de Mallorca, Islas Baleares, España., Bonnín O; Servicio de Cirugía Cardiaca, Hospital Universitari Son Espases, Palma de Mallorca, Islas Baleares, España., Ibáñez J; Unidad de Cuidados Intensivos, Hospital Universitari Son Espases, Palma de Mallorca, Islas Baleares, España.
Jazyk:	Spanish; Castilian
Zdroj:	Revista de calidad asistencial : organo de la Sociedad Espanola de Calidad Asistencial [Rev Calid Asist] 2016 May-Jun; Vol. 31 (3), pp. 126-33. Date of Electronic Publication: 2016 May 17.
DOI:	10.1016/j.cali.2016.03.007
Abstrakt:	Objective: This study analyses the rate of post-operative complications after cardiac surgery, the incidence of the failure to rescue (FR), and the relationship between complications and survival. Methods: The study included a total of 2,750 adult patients operated of cardiac surgery between January 2003 and December 2009. An analysis was made of 9 post-operative complications. Multiple logistic regression analysis was used to find independent variables associated with any of the selected complications. Survival was analysed with Kaplan-Meyer survival estimates. A risk-adjusted Cox proportional regression model was used to find out which complications were associated with mid-term survival. Results: Hospital mortality rate was 1.4% (95% CI: 1.0%-1.9%). Postoperative complications rate was 38.5% (36.7%-40.4%), and FR 3.6% (2.5%-4.9%). Urgent surgery (OR = 2.03; 1.52-2.72), chronic renal failure (OR = 1.50, 95%.CI: 1.25-1.80), and age ≥70 years (OR = 1.42; 1.20-1.68) were the variables that showed the highest strength of association with the selected complications. Survival at 5 years in the group of patients without complications was 93%, and in the group of patients with complications it was 83% (P<.0001). Postoperative complications associated with mid-term survival were pneumonia (HR = 2.6, 95% CI; 1.27-5.50), acute myocardial infarction (HR = 1.9; 1.10-2.30), and acute renal failure (HR = 1.7; 1.30-2.26). Conclusions: The incidence of complications after cardiac surgery is around 40%, and was associated with an increase in hospital mortality, although FR was very low (3.6%; 95% CI: 2.5-4.9). (Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.)
Databáze:	MEDLINE
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