Table 1 Baseline and intra-operative characteristics of patients with ejection fraction ≤40 % who underwent cardiac surgery: comparisons between survivors and dead patients
From: Outcome of cardiac surgery in patients with low preoperative ejection fraction
Variable | Total (N = 781) | Survivors (N = 737) | Dead (N = 44) | P-value |
|---|---|---|---|---|
Preoperative characteristics | ||||
Gender (Male), n | 597 (76 %) | 569 (77 %) | 28 (64 %) | 0.04 |
Age, years | 65.4 ± 10.3 | 65.3 ± 10.4 | 68.4 ± 9.4 | 0.0575 |
Height, cm | 169.6 ± 8.1 | 169.7 ± 8.0 | 167.6 ± 9.4 | 0.2 |
Weight, kg | 73.7 ± 13.4 | 73.8 ± 13.3 | 71.2 ± 14.6 | 0.2 |
BMI | 25.6 ± 4.0 | 25.6 ± 4.0 | 25.4 ± 4.4 | 0.8 |
Comorbidity | ||||
> COPD, n | 235 (30 %) | 210 (28 %) | 25 (57 %) | <0.001 |
> Preoperative EF, % | 33.9 ± 6.1 | 34.0 ± 6.1 | 31.8 ± 6.0 | 0.01 |
> Preoperative EF ≤ 40 %, n | 781 (100 %) | |||
> Preoperative EF ≤ 30 %, n | 290 (37 %) | |||
> Peripheral vasculopathy, n | 196 (25 %) | 183 (25 %) | 13 (30 %) | 0.5 |
> Arterial hypertension, n | 423 (54 %) | 402 (55 %) | 21 (48 %) | 0.4 |
> Type II diabetes mellitus, n | 159 (20 %) | 151 (20 %) | 8 (18 %) | 0.7 |
> Carotid stenosis, n | 71 (9.1 %) | 68 (9.2 %) | 3 (6.8 %) | 0.8 |
> Angina, n | 112 (14 %) | 104 (14 %) | 8 (18 %) | 0.5 |
> Previous AMI, n | 243 (31 %) | 227 (31 %) | 16 (36 %) | 0.4 |
> Previous TIA or stroke, n | 61 (7.8 %) | 58 (7.9 %) | 3 (6.8 %) | 0.99 |
> Previous vascular surgery, n | 37 (4.7 %) | 37 (5 %) | 0 (0 %) | 0.3 |
> Standard EuroSCORE | 6 (4–8) | 6 (4–8) | 8 (6–10) | <0.001 |
> ACEF score | 2.08 (1.77–2.47) | 2.06 (1.75–2.44) | 2.43 (2.08–3.16) | <0.001 |
> ACEF risk | 5.59 (3.89–8.78) | 5.46 (3.81–8.56) | 8.45 (5.61–18.52) | <0.001 |
> Endocarditis, n | 22 (2.8 %) | 20 (2.7 %) | 2 (4.5) | 0.4 |
> Creatinine clearance, ml/h | 65.1 (49.2–82.6) | 65.67 (50.23–83.33) | 49.1 (39.66–69.27) | 0.002 |
> Chronic renal failure, n | 149 (19 %) | 134 (18 %) | 15 (34 %) | 0.009 |
> Dialysis, n | 13 (1.7 %) | 12 (1.6 %) | 1 (2.3 %) | 0.5 |
NYHA | 0.003 | |||
> I | 51 (6.5 %) | 51 (6.9 %) | 0 (0 %) | |
> II | 208 (27 %) | 201 (27 %) | 7 (16 %) | |
> III | 276 (35 %) | 267 (36 %) | 9 (20 %) | |
> IV | 43 (5.5 %) | 36 (4.9 %) | 7 (16 %) | |
Timing of surgery | 0.2 | |||
> Emergency, n | 18 (2.3 %) | 16 (2.2 %) | 2 (4.5 %) | |
> Urgency, n | 129 (17 %) | 119 (16 %) | 10 (23 %) | |
> Election, n | 634 (81 %) | 602 (82 %) | 32 (73 %) | |
Redo surgery, n | 81 (10 %) | 73 (9.9 %) | 8 (18 %) | 0.08 |
Preoperative IABP, n | 135 (17 %) | 121 (16 %) | 14 (32 %) | 0.009 |
Preoperative inotropes, n | 17 (2.2 %) | 11 (1.5 %) | 6 (14 %) | <0.001 |
Chronic therapy | ||||
> Antiplatelets, n | 267 (34 %) | 258 (35 %) | 9 (20 %) | 0.048 |
> Diuretics, n | 503 (64 %) | 470 (64 %) | 33 (75 %) | 0.13 |
> Beta-blockers, n | 365 (47 %) | 353 (48 %) | 12 (27 %) | 0.008 |
> Antibiotics, n | 38 (4.9 %) | 34 (4.6 %) | 4 (9.1 %) | 0.16 |
> Calcium channel blockers, n | 128 (16 %) | 121 (16 %) | 7 (16 %) | 0.9 |
> Nitrates, n | 217 (28 %) | 205 (28 %) | 12 (27 %) | 0.9 |
> ACE inhibitors, n | 496 (64 %) | 473 (64 %) | 23 (52 %) | 0.11 |
> Oral anticoagulants, n | 135 (17 %) | 130 (18 %) | 5 (11 %) | 0.4 |
> Heparin, n | 61 (7.8 %) | 57 (7.7 %) | 4 (9.1 %) | 0.8 |
Creatinine, mg/dl | 1.2 ± 0.9 | 1.2 ± 0.9 | 1.5 ± 1.1 | 0.004 |
Bilirubin, mg/dl | 0.8 (0.57–1.1) | 0.8 (0.57–1.04) | 0.94 (0.63–1.4) | 0.1 |
Surgical interventions | ||||
CABG, n | 390 (31 %) | 373 (31 %) | 17 (23 %) | 0.12 |
> Isolated CABG, n | 189 (15 %) | 185 (16 %) | 4 (5.4 %) | 0.02 |
Mitral valve surgery, n | 282 (22 %) | 258 (22 %) | 24 (32 %) | 0.009 |
> Isolated mitral valve surgery, n | 90 (7.1 %) | 84 (7.1 %) | 6 (8.1 %) | 0.7 |
> Mitral valve replacement, n | 126 (10 %) | 117 (9.9 %) | 9 (12 %) | 0.4 |
> Mitral valve repair, n | 156 (12 %) | 141 (12 %) | 15 (20 %) | 0.02 |
Aortic valve surgery, n | 241 (19 %) | 227 (19 %) | 14 (19 %) | 0.9 |
> Isolated aortic valve surgery, n | 81 (6.4 %) | 76 (6.4 %) | 5 (6.8 %) | 0.8 |
> Aortic valve replacement, n | 241 (19 %) | 227 (19 %) | 14 (19 %) | 0.9 |
> Aortic valve repair, n | 1 (0.08 %) | 1 (0.08 %) | 0 (0 %) | 0.99 |
Tricuspid valve surgery, n | 96 (7.6 %) | 91 (7.7 %) | 5 (6.8 %) | 0.99 |
> Isolated tricuspid valve surgery, n | 3 (0.24 %) | 3 (0.25 %) | 0 (0 %) | 0.99 |
> Tricuspid valve replacement, n | 6 (0.48 %) | 6 (0.51 %) | 0 (0 %) | 0.99 |
> Tricuspid valve repair, n | 90 (7.1 %) | 85 (7.2 %) | 5 (6.8 %) | 0.99 |
Pulmonic valve surgery, n | 1 (0.08 %) | 1 (0.08 %) | 0 (0 %) | 0.99 |
> Isolated pulmonic valve surgery, n | 1 (0.08 %) | 1 (0.08 %) | 0 (0 %) | 0.99 |
Surgery on ascending aorta, n | 83 (6.6 %) | 76 (6.4 %) | 7 (9.5 %) | 0.2 |
> Isolated surgery on ascending aorta, n | 6 (0.48 %) | 6 (0.51 %) | 0 (0 %) | 0.99 |
Left ventricle surgery, n | 77 (6.1 %) | 76 (6.4 %) | 1 (1.4 %) | 0.11 |
> Isolated left ventricle surgery, n | 12 (0.95 %) | 12 (1 %) | 0 (0 %) | 0.99 |
Intraoperative management | ||||
CPB, n | 696 (91 %) | 656 (89 %) | 40 (91 %) | 0.4 |
Duration of aortic cross clamping, min | 61 (48–78) | 61 (47–78) | 69.5 (51–78) | 0.3 |
Duration of CPB, min | 85 (65–102) | 84 (65–101) | 95 (70–114) | 0.3 |