Outcome analysis for prediction of early and long-term survival in patients receiving intra-aortic balloon pumping after cardiac surgery
著者
紙谷, 寛之
(Kamiya, Hiroyuki)
Maximilian, Schilling
Payam, Akhyari
Arjang, Ruhparwar
Klaus, Kallenbach
Matthias, Karck
Artur, Lichtenberg
上位タイトル
General Thoracic and Cardiovascular Surgery
Vol.64,
No.10
(2016.
10)
,p.584-
591
識別番号
ISSN
1863-6705
DOI
10.1007/s11748-016-0679-3
その他
PMID：27456851
抄録
BACKGROUND:
Patients requiring an intra-aortic balloon pump (IABP) after cardiac surgery are critically ill and need a prolonged ICU stay. Considering limited health care resources, the early identification of patients with an extremely poor prognosis is important as a solid base for the decision whether further aggressive continuation or cessation of the therapy is recommendable.
METHODS:
From 2001 to 2007, 552 patients with low-output syndrome after open-heart surgery and IABP implantation in OR or within 24 h thereafter on ICU were retrospectively analyzed.
RESULTS:
The overall mortality at 30 and 180-day were 31 and 40 %, respectively. According to multivariate analyses, following factors were used to generate an IABP score: female gender, age ≥70 years, simultaneous coronary and valve surgery, aortic cross-clamp time >120 min., need of norepinephrin more than 0.4 µg kg(-1) min(-1), postoperative dialysis, and maximal serum creatinine kinase >3000 mg mL(-1). The 30-day mortality continuously increased along the score (10.1 % for score = 0, n = 98; 11.8 % for score = 1, n = 144; 27.5 % for score = 2, n = 153; 40.4 % score = 3, n = 89; 65.2 % for score = 4, n = 46; 77.8 % for score = 5, n = 27) and reached 100 % for all patients with a score of 6 (n = 4).
CONCLUSIONS:
Prediction of 30 days mortality was possible with our scoring system based on multivariate analysis, and patients with scores of 4 or greater had remarkably worse early and late survival.
