Most deaths in low-risk cardiac surgery could be avoidable

Autor:	Marco Antonio Praça Oliveira, Valquiria Pelisser Campagnucci, Marcos Gradim Tiveron, Marcelo Arruda Nakazone, Roberto Rocha e Silva, Omar Mejía, Rafael Ângelo Tineli, Gabrielle Barbosa Borgomoni, Orlando Petrucci Junior, Walter J. Gomes, Luís Roberto Palma Dallan, Eduardo Gomes Lima, Pedro Gabriel Melo de Barros e Silva, Fabio Biscegli Jatene, Gustavo Pampolha Guerreiro, Luiz Augusto Ferreira Lisboa, Alexandre Sousa, Alfredo José Rodrigues
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Male medicine.medical_specialty medicine.medical_treatment Science MEDLINE Cardiology 030204 cardiovascular system & hematology Logistic regression Article law.invention Sepsis 03 medical and health sciences 0302 clinical medicine law Cause of Death Coronary stent medicine Humans Registries Cardiac Surgical Procedures Aged Aged 80 and over Multidisciplinary business.industry Mortality rate Middle Aged medicine.disease ANÁLISE DE SOBREVIVÊNCIA Intensive care unit Survival Analysis Cardiac surgery medicine.anatomical_structure 030228 respiratory system Risk factors Emergency medicine Medicine Female Patient Safety business Interventional cardiology Brazil Artery
Zdroj:	Scientific Reports, Vol 11, Iss 1, Pp 1-8 (2021) Scientific Reports Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP
ISSN:	2045-2322
Popis:	It is observed that death rates in cardiac surgery has decreased, however, root causes that behave like triggers of potentially avoidable deaths (AD), especially in low-risk patients (less bias) are often unknown and underexplored, Phase of Care Mortality Analysis (POCMA) can be a valuable tool to identify seminal events (SE), providing valuable information where it is possible to make improvements in the quality and safety of future procedures. Our results show that in São Paul State, only one third of AD in low-risk cardiac surgery was related to specific surgical problems. After a revisited analysis, 75% of deaths could have been avoided, which in the pre-operative phase, the SE was related judgment, patient evaluation and preparation. In the intra-operative phase, most occurrences could have been avoided if other surgical technique had been used. Sepsis was responsible for 75% of AD in the intensive care unit. In the ward phase, the recognition/management of clinical decompensations and sepsis were the contributing factors. Logistic regression model identified age, previous coronary stent implantation, coronary artery bypass grafting + heart valve surgery, ≥ 2 combined heart valve surgery and hospital-acquired infection as independent predictors of AD.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8c27d0c4a36dc9dbcbf5dde497459a71 https://doaj.org/article/8f79c469ae6b4df0b97f6de86a231d57 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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