Healy David G, Veerasingam Devendran, Wood Alfred E
Prof. Eoin O'Malley National Centre for Cardiothoracic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
Heart Surg Forum. 2006;9(6):E893-6. doi: 10.1532/HSF98.20061037.
The placement of preoperative intra-aortic balloon pumps (IABP) in high-risk patients has been described, although controversy remains regarding the appropriate selection of these patients. The EuroSCORE is a proven predictor of operative mortality for coronary artery bypass surgery (CABG). Our objective was to assess whether patients with a preoperative IABP had a 30-day mortality consistent with their predicted mortality.
Sixty-sis patients who had had an IABP sited while undergoing CABG were retrospectively identified. The additive EuroSCORE was calculated with omission of the IABP preoperative placement score of 3 points. Patients with a EuroSCORE <5 were considered low risk, and those > or = m5 as high risk.
High-risk patients with preoperative IABP placement had a significantly lower mortality (1/16, 6.25%) than predicted. The predicted versus actual mortality was 12.6% versus 6.25%.
Correct identification of appropriate patients who would benefit from pre-emptive placement of IABP could potentially be performed using the EuroSCORE.
尽管对于高危患者术前主动脉内球囊反搏（IABP）的放置已有相关描述，但在这些患者的恰当选择方面仍存在争议。欧洲心脏手术风险评估系统（EuroSCORE）是冠状动脉旁路移植术（CABG）手术死亡率的有效预测指标。我们的目的是评估术前使用IABP的患者30天死亡率是否与其预测死亡率相符。
回顾性确定66例在接受CABG时放置IABP的患者。计算累加欧洲心脏手术风险评估系统评分时，不包括术前IABP放置的3分。欧洲心脏手术风险评估系统评分<5分的患者被视为低风险，≥5分的患者为高风险。
术前放置IABP的高危患者死亡率（1/16，6.25%）显著低于预测值。预测死亡率与实际死亡率分别为12.6%和6.25%。
使用欧洲心脏手术风险评估系统有可能正确识别那些将从预防性放置IABP中获益的合适患者。
