Riera María, Herrero Jaime, Ibáñez Jordi, Campillo Carlos, Amézaga Rocío, Sáez de Ibarra José I, Fiol Miguel, Bonnín Oriol
Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, Palma, Islas Baleares, España.
Rev Esp Cardiol. 2011 Jun;64(6):463-9. doi: 10.1016/j.recesp.2010.12.015. Epub 2011 Apr 16.
Evaluating patient outcomes following cardiac surgery is a means of measuring the quality of that surgery. The present study analyzes survival and the risk factors associated with mid-term mortality of patients undergoing cardiac surgery in Son Dureta University Hospital (Palma, Balearic Islands, Spain).
From November 2002 thru December 2007, 1938 patients underwent interventions. Patients were stratified in 4 age groups. Of 1900 patients discharged from hospital, 1844 were followed until December 31, 2008. Following discharge, we constructed Kaplan-Meier survival curves and performed Cox regression analysis to determine which variables associated with mid-term mortality.
In-hospital mortality of the 1,938 patients was 1.96% (CI 95%, 1.36%-2.6%). Survival probability at 1, 3 and 5 years follow-up was 98%, 94% and 90%, respectively. Mean follow-up was 3.2 (0.01-6.06) years. Patients aged ≥ 70 years showed a lower survival rate than those aged <70 (log rank test, P <.0001). At the end of follow-up, mortality was 6.5% (CI 95%, 5.4%-7.7%). Age ≥ 70 years, a history of severe ventricular dysfunction (ejection fraction < 30%), severe pulmonary hypertension, diabetes mellitus, preoperative anemia, postoperative stroke, and hospital stay were independently associated with mid-term mortality.
Mid-term survival after discharge was highly satisfactory. Mid-term mortality varied with age and other pre- and postoperative factors.
评估心脏手术后的患者预后是衡量该手术质量的一种方式。本研究分析了在西班牙巴利阿里群岛帕尔马市的Son Dureta大学医院接受心脏手术患者的生存率及与中期死亡率相关的危险因素。
2002年11月至2007年12月期间，1938例患者接受了手术干预。患者被分为4个年龄组。在1900例出院患者中，1844例被随访至2008年12月31日。出院后，我们构建了Kaplan-Meier生存曲线，并进行Cox回归分析以确定哪些变量与中期死亡率相关。
1938例患者的院内死亡率为1.96%（95%置信区间，1.36%-2.6%）。随访1年、3年和5年时的生存概率分别为98%、94%和90%。平均随访时间为3.2（0.01-6.06）年。年龄≥70岁的患者生存率低于年龄<70岁的患者（对数秩检验，P<.0001）。随访结束时，死亡率为6.5%（95%置信区间，5.4%-7.7%）。年龄≥70岁、严重心室功能障碍病史（射血分数<30%）、严重肺动脉高压、糖尿病、术前贫血、术后中风和住院时间与中期死亡率独立相关。
出院后的中期生存率非常令人满意。中期死亡率随年龄及其他术前和术后因素而变化。
