The association of complication type with mortality and prolonged stay after cardiac surgery with cardiopulmonary bypass

Ian J. Welsby, Elliott Bennett-Guerrero, Darryl Atwell, William D. White, Mark F. Newman, Peter K. Smith, Michael G. Mythen

Research output: Contribution to journalArticlepeer-review

78 Scopus citations

Abstract

Outcome after cardiac surgery varies depending on complication type. We therefore sought to determine the association between complication type, mortality, and length of stay in a large series of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Multivariate logistic regression was used to test for differences between complication types in mortality and prolonged length of stay (>10 days) while controlling for preoperative and intraoperative risk factors. In 2609 consecutive cardiac surgical patients requiring CPB, the mortality rate was 3.6%; 36.5% had one or more complications, and 15.7% experienced an adverse outcome (death or prolonged length of stay). Multivariate logistic regression demonstrated that complication type was significantly associated with adverse outcome (P < 0.001) independent of Parsonnet score and CPB time (c-index = 0.80). The development of noncardiac complications only (Group NC) and cardiac complications with other organ involvement (Group B) significantly increased mortality and hospital and intensive care unit length of stay (P < 0.001) when compared with cardiac complications only (Group C). The incidences of adverse outcome in Groups C, NC, and B were 15%, 43%, and 67%, respectively; the mortality rates were 3%, 7%, and 20%, respectively. All these intergroup comparisons were significantly different (adjusted P < 0.05). Complications involving organs other than the heart appear to be more deleterious than cardiac complications alone, underscoring the need for strategies to reduce noncardiac complications.

Original languageEnglish
Pages (from-to)1072-1078
Number of pages7
JournalAnesthesia and Analgesia
Volume94
Issue number5
DOIs
StatePublished - 2002

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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