Risk factor analysis of postoperative acute respiratory distress syndrome in valvular heart surgery

被引:24
作者
Chen, Shao-Wei [1 ,2 ]
Chang, Chih-Hsiang [2 ,3 ]
Chu, Pao-Hsien [4 ]
Chen, Tien-Hsing [4 ]
Wu, Victor Chien-Chia [4 ]
Huang, Yao-Kuang [1 ]
Liao, Chien-Hung [5 ]
Wang, Shang-Yu [2 ,5 ]
Lin, Pyng-Jing [1 ]
Tsai, Feng-Chun [1 ]
机构
[1] Chang Gung Mem Hosp, Linkou Med Ctr, Dept Cardiothorac & Vasc Surg, Taoyuan 33305, Taiwan
[2] Chang Gung Univ, Coll Med, Grad Inst Clin Med Sci, Taoyuan, Taiwan
[3] Chang Gung Mem Hosp, Linkou Med Ctr, Dept Nephrol, Kidney Res Ctr, Taoyuan 33305, Taiwan
[4] Chang Gung Mem Hosp, Linkou Med Ctr, Dept Cardiol, Taoyuan 33305, Taiwan
[5] Chang Gung Mem Hosp, Linkou Med Ctr, Dept Traumatol & Emergency Surg, Taoyuan 33305, Taiwan
关键词
Valvular heart surgery; Acute respiratory distress syndrome; TRICUSPID-VALVE SURGERY; ACUTE LUNG INJURY; CARDIAC-SURGERY; MULTICENTER COHORT; BERLIN DEFINITION; PREDICTION; ARDS;
D O I
10.1016/j.jcrc.2015.11.002
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose: The aim of this study is to investigate the incidence, severity, and outcome of postoperative acute respiratory distress syndrome (ARDS), according to the Berlin definition, in isolated valvular heart surgery. The preoperative and perioperative predisposing factors of this complication were also identified. Methods: A retrospective chart review was conducted on 457 patients who underwent isolated valvular heart surgery between January 2010 and December 2012. Clinical characteristics and outcomes were collected. The primary outcome was postoperative ARDS, according to the 2012 Berlin definition for ARDS. Results: A total of 37 patients (8.1%) developed postoperative ARDS, with a mortality rate of 29.7%. The multivariate analysis identified that age (odds ratios [ORs], 1.067, P <= .001), liver cirrhosis (OR, 7.159; P = .001), massive blood transfusion (OR, 2.980; P = .005), and tricuspid valve replacement (OR, 5.197; P = .012) were independent risk factors of postoperative ARDS. Furthermore, we have determined that the increased severity stages of ARDS were associated with decreased postoperative survival. Conclusions: In conclusion, postoperative ARDS, according to Berlin definition, in valvular surgery, was associated with high in-hospital mortality. The severity of ARDS was associated with patient midterm mortality. In multivariate analysis, age, liver cirrhosis, massive blood transfusion, and tricuspid valve replacement were identified as independent risk factors of ARDS. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:139 / 143
页数:5
相关论文
共 21 条
[1]   Prevalence of acute respiratory distress syndrome after cardiac surgery [J].
Asimakopoulos, G ;
Taylor, KM ;
Smith, PL ;
Ratnatunga, CP .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1999, 117 (03) :620-621
[2]   Surgical Risk and Outcome of Repair Versus Replacement for Late Tricuspid Regurgitation in Redo Operation [J].
Chen, Shao-Wei ;
Tsai, Feng-Chun ;
Tsai, Feng-Chang ;
Chao, Yin-Kai ;
Huang, Yao-Kuang ;
Chu, Jaw-Ji ;
Lin, Pyng-Jing .
ANNALS OF THORACIC SURGERY, 2012, 93 (03) :770-775
[3]   Hospital costs associated with surgical complications: A report from the private-sector national surgical quality improvement program [J].
Dimick, JB ;
Chen, SL ;
Taheri, PA ;
Henderson, WG ;
Khuri, SF ;
Campbell, DA .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2004, 199 (04) :531-537
[4]   The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material [J].
Ferguson, Niall D. ;
Fan, Eddy ;
Camporota, Luigi ;
Antonelli, Massimo ;
Anzueto, Antonio ;
Beale, Richard ;
Brochard, Laurent ;
Brower, Roy ;
Esteban, Andres ;
Gattinoni, Luciano ;
Rhodes, Andrew ;
Slutsky, Arthur S. ;
Vincent, Jean-Louis ;
Rubenfeld, Gordon D. ;
Thompson, B. Taylor ;
Ranieri, V. Marco .
INTENSIVE CARE MEDICINE, 2012, 38 (10) :1573-1582
[5]   Intraoperative ventilator settings and acute lung injury after elective surgery: a nested case control study [J].
Fernandez-Perez, E. R. ;
Sprung, J. ;
Afessa, B. ;
Warner, D. O. ;
Vachon, C. M. ;
Schroedere, D. R. ;
Brown, D. R. ;
Hubmayr, R. D. ;
Gajic, O. .
THORAX, 2009, 64 (02) :121-127
[6]   ADULT RESPIRATORY-DISTRESS SYNDROME - RISK WITH COMMON PREDISPOSITIONS [J].
FOWLER, AA ;
HAMMAN, RF ;
GOOD, JT ;
BENSON, KN ;
BAIRD, M ;
EBERLE, DJ ;
PETTY, TL ;
HYERS, TM .
ANNALS OF INTERNAL MEDICINE, 1983, 98 (05) :593-597
[7]   Early Identification of Patients at Risk of Acute Lung Injury Evaluation of Lung Injury Prediction Score in a Multicenter Cohort Study [J].
Gajic, Ognien ;
Dabbagh, Ousama ;
Park, Pauline K. ;
Adesanya, Adebola ;
Chang, Steven Y. ;
Hou, Peter ;
Anderson, Harry, III ;
Hoth, J. Jason ;
Mikkelsen, Mark E. ;
Gentile, Nina T. ;
Gong, Michelle N. ;
Talmor, Daniel ;
Bajwa, Ednan ;
Watkins, Timothy R. ;
Festic, Emir ;
Yilmaz, Murat ;
Iscimen, Remzi ;
Kaufman, David A. ;
Esper, Annette M. ;
Sadikot, Ruxana ;
Douglas, Ivor ;
Sevransky, Jonathan ;
Malinchoc, Michael .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2011, 183 (04) :462-470
[8]   Tricuspid valve surgery: a thirty-year assessment of early and late outcome [J].
Guenther, Thomas ;
Noebauer, Christian ;
Mazzitelli, Domenico ;
Busch, Raymonde ;
Tassani-Prell, Peter ;
Lange, Ruediger .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2008, 34 (02) :402-409
[9]   Functional Disability 5 Years after Acute Respiratory Distress Syndrome [J].
Herridge, Margaret S. ;
Tansey, Catherine M. ;
Matte, Andrea ;
Tomlinson, George ;
Diaz-Granados, Natalia ;
Cooper, Andrew ;
Guest, Cameron B. ;
Mazer, C. David ;
Mehta, Sangeeta ;
Stewart, Thomas E. ;
Kudlow, Paul ;
Cook, Deborah ;
Slutsky, Arthur S. ;
Cheung, Angela M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 364 (14) :1293-1304
[10]   Trends and Outcomes of Tricuspid Valve Surgery in North America: An Analysis of More Than 50,000 Patients From The Society of Thoracic Surgeons Database [J].
Kilic, Arman ;
Saha-Chaudhuri, Paramita ;
Rankin, J. Scott ;
Conte, John V. .
ANNALS OF THORACIC SURGERY, 2013, 96 (05) :1546-1552