Sá Michel Pompeu Barros de Oliveira, Nogueira Joana Rosa Costa, Ferraz Paulo Ernando, Figueiredo Omar Jacobina, Cavalcante Wagner Cid Palmeira, Cavalcante Thiago Cid Palmeira, Silva Hugo Thiago Torres da, Santos Cecília Andrade, Lima Renato Oliveira de Albuquerque, Vasconcelos Frederico Pires, Lima Ricardo de Carvalho
Rev Bras Cir Cardiovasc. 2012 Apr-Jun;27(2):217-23. doi: 10.5935/1678-9741.20120037.
Low cardiac output syndrome (LCOS) is a serious complication after cardiac surgery and is associated with significant morbidity and mortality. The aim of this study is to identify risk factors for LCOS in patients undergoing coronary artery bypass grafting (CABG) in the Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE (Recife, PE, Brazil).
A historical prospective study comprising 605 consecutive patients operated between May 2007 and December 2010. We evaluated 12 preoperative and 7 intraoperative variables. We applied univariate and multivariate logistic regression analysis.
The incidence of LCOS was 14.7% (n = 89), with a lethality rate of 52.8% (n = 47). In multivariate analysis by logistic regression, four variables remained as independent risk factors: age > 60 years (OR 2.00, 95% CI 1.20 to 6.14, P = 0.009), on-pump CABG (OR 2.16, 95% CI 1.40 to 7.08, P = 0.006), emergency surgery (OR 4.71, 95% CI 1.34 to 26.55, P = 0.028), incomplete revascularization (OR 2.62, 95% CI 1.32 to 5.86, P = 0.003), and ejection fraction <50%.
This study identified the following independent risk factors for LCOS after CABG: age> 60 years of off-pump CABG, emergency surgery, incomplete CABG and ejection fraction <50%.
低心排血量综合征（LCOS）是心脏手术后的一种严重并发症，与显著的发病率和死亡率相关。本研究的目的是确定在巴西累西腓普罗康佩心血管外科（Pronto Socorro Cardiológico de Pernambuco - PROCAPE）接受冠状动脉旁路移植术（CABG）的患者中LCOS的危险因素。
一项历史性前瞻性研究，纳入了2007年5月至2010年12月期间连续接受手术的605例患者。我们评估了12个术前变量和7个术中变量。我们应用了单因素和多因素逻辑回归分析。
LCOS的发生率为14.7%（n = 89），死亡率为52.8%（n = 47）。在逻辑回归的多因素分析中，四个变量仍为独立危险因素：年龄>60岁（OR 2.00，95%CI 1.20至6.14，P = 0.009）、体外循环下CABG（OR 2.16，95%CI 1.40至7.08，P = 0.006）、急诊手术（OR 4.71，95%CI 1.34至26.55，P = 0.028）、血管重建不完全（OR 2.62，95%CI 1.32至5.86，P = 0.003）以及射血分数<50%。
本研究确定了CABG术后LCOS的以下独立危险因素：年龄>60岁、非体外循环下CABG、急诊手术、CABG不完全以及射血分数<50%。
