TY - JOUR
T1 - Preexisting heart failure is an underestimated risk factor in cardiac surgery
AU - Kortekaas, K. A.
AU - Lindeman, J. H. N.
AU - Versteegh, M. I. M.
AU - Stijnen, T.
AU - Dion, R. A. E.
AU - Klautz, R. J. M.
PY - 2012
Y1 - 2012
N2 - Background Heart failure is characterised as a strong risk factor for systemic failure after cardiac surgery. However, the impact has never been substantiated. Methods Patients with heart failure (n=48) - scheduled for elective ventricular reconstruction or external constraint device-were compared with a one-to-one matched control group of patients without heart failure undergoing cardiac surgery between 2006 and 2009. Results As expected, patients with heart failure more frequently experienced complications definitely related to pump failure (p=0.01). However, complications not related to their pump failure were also more often observed, such as prolonged mechanical ventilation, sepsis and vasoplegia (p=0.01). Overall, organ dysfunction-circulatory, renal, and pulmonary failure-was often observed in heart failure patients, contributing to a prolonged stay in the intensive care unit (p<0.001) as well as in hospital (p=0.01). Conclusion The adverse postoperative course in patients with heart failure is not only directly related to circulatory failure, but merely reflects a systemic dysregulation. Our findings suggest that heart failure impacts outcome and should therefore be included in prevailing risk classification systems. Offensive perioperative treatment strategies, focused on the main complications in patients with heart failure, will lead to improved results after cardiac surgery. © Springer Media / Bohn Stafleu van Loghum 2012.
AB - Background Heart failure is characterised as a strong risk factor for systemic failure after cardiac surgery. However, the impact has never been substantiated. Methods Patients with heart failure (n=48) - scheduled for elective ventricular reconstruction or external constraint device-were compared with a one-to-one matched control group of patients without heart failure undergoing cardiac surgery between 2006 and 2009. Results As expected, patients with heart failure more frequently experienced complications definitely related to pump failure (p=0.01). However, complications not related to their pump failure were also more often observed, such as prolonged mechanical ventilation, sepsis and vasoplegia (p=0.01). Overall, organ dysfunction-circulatory, renal, and pulmonary failure-was often observed in heart failure patients, contributing to a prolonged stay in the intensive care unit (p<0.001) as well as in hospital (p=0.01). Conclusion The adverse postoperative course in patients with heart failure is not only directly related to circulatory failure, but merely reflects a systemic dysregulation. Our findings suggest that heart failure impacts outcome and should therefore be included in prevailing risk classification systems. Offensive perioperative treatment strategies, focused on the main complications in patients with heart failure, will lead to improved results after cardiac surgery. © Springer Media / Bohn Stafleu van Loghum 2012.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84866261641&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/22351559
U2 - https://doi.org/10.1007/s12471-012-0257-y
DO - https://doi.org/10.1007/s12471-012-0257-y
M3 - Article
C2 - 22351559
SN - 1568-5888
VL - 20
SP - 202
EP - 207
JO - Netherlands heart journal
JF - Netherlands heart journal
IS - 5
ER -