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J Cardiothorac Vasc Anesth. 2016 Apr;30(2):338-44. doi: 10.1053/j.jvca.2015.08.006. Epub 2015 Aug 10.

Rate of Major Anesthetic-Related Outcomes in the Intraoperative and Immediate Postoperative Period After Cardiac Surgery.

Author information

1
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
2
Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL.
3
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA; Anesthesia Quality Institute, Schaumburg, IL. Electronic address: rurman@partners.org.

Abstract

OBJECTIVES:

To examine anesthesia-centered outcomes in a large cohort of patients undergoing coronary artery bypass grafting (CABG) or valvular heart surgery.

DESIGN:

A retrospective study with univariate and multivariate logistic regression to identify independent predictors for mortality.

SETTING:

Diverse setting including university, small, medium, and large community hospitals.

PARTICIPANTS:

All patients undergoing CABG or valve surgery in the National Anesthesia Clinical Outcomes Registry (NACOR) from the Anesthesia Quality Institute.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Common anesthesia-centered outcomes including arrhythmia, cardiac arrest, death, hemodynamic instability, hypotension, inadequate pain control, nausea/vomiting, seizure, stroke, reintubation and transfusion were reported. All outcomes, consistent with NACOR data entry, were defined as occurring intraoperatively or during phase I or II recovery in the PACU. Death occurred in 0.15% of CABGs and 0.23% of valve surgeries. Age less than 18, American Society of Anesthesiologists physical status (ASA PS) classification of 5, and mean case duration greater than 6 hours were associated with increased mortality (p<0.05). The presence of a board-certified anesthesiologist was associated with decreased odds for mortality.

CONCLUSIONS:

Death was a rare outcome in this cohort, reflecting the infrequent occurrence of intraoperative or immediate postoperative death. The presence of a board-certified anesthesiologist represented a modifiable risk factor for reducing mortality risk.

KEYWORDS:

CABG; anesthesiology; cardiac surgery; mortality; outcomes; valve surgery

PMID:
26708695
DOI:
10.1053/j.jvca.2015.08.006
[Indexed for MEDLINE]

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