- Oral presentation
- Open Access
Predictors of in-hospital adverse outcomes in aortic surgery
© Sales et al; licensee BioMed Central Ltd. 2013
- Published: 11 September 2013
- Hybrid Procedure
- Aortic Disease
- Endovascular Approach
- Concomitant Procedure
- Aortic Root Replacement
Aortic surgery is associated with high rates of death and complications. Our aim was to describe short-term outcomes after aortic surgery, and to identify predictors of adverse in-hospital outcomes.
All patients operated on for aortic diseases (2009-2012) were included. We evaluated demographic, clinical and operative variables, in-hospital mortality and MACCE.
We included 235 pts (61±13y, 66%male). Group 1 (aneurysms 61%) and Group 2 (dissections, ulcer, hematoma 36%). Others: 3%. Procedures: aortic root replacement (26,5%), Bentall procedure (23,5%), endovascular (28%), hybrid surgery (19%), aortoplasty and Tirone (3%); concomitant procedures in 20% of cases. Group 2 had higher BP, more urgent and hybrid procedures, greater pump/ischemia time, smaller aortic size and less Bentall procedure. Mortality was 8,5% (Group 1, 4,6%; Group 2, 15,5%, p=0,004). Rate of MACCE was 19,2% (Group 1, 11,3%; Group 2, 33,7%, p<0,001). Reoperation occurred in 7,3%, complications 34,2%, stroke 4,3%, AKIN 7,3%, respiratory complications 15,9%. Medullary ischemia developed in 2 patients (0,8%). By multivariate logistic regression, independent predictors of death were hybrid procedure [OR=7,51 (1,05–53,4) p=0,044], aortic size [OR=1,05 (1,02-1,10) p=0,005] and pump time [OR=1,10 (1,01–1,20) p=0,034]; predictors of MACCE were urgent surgery [OR=7,17 (1,10-49,5) p=0,045], combined aneurysms [22,4 (1,42-353) p=0,027], and concomitant mitral valve surgery [OR=46,5 (1,3-166) p=0,035]. Endovascular procedure was independently associated with reduction of MACCE incidence [OR=0,05 (0,004-0,730) p=0,045].
Aortic surgery in a specialized center is associated with low rates of in-hospital death and MACCE. Independent predictors of in-hospital death were the hybrid approach, aortic size and bypass time; predictors of MACCE included urgent surgery, combined aneurisms and concomitant mitral surgery. Endovascular approach independently reduced MACCE.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.