Document Detail


A clinical score to predict the need for intraaortic balloon pump in patients undergoing coronary artery bypass grafting.
MedLine Citation:
PMID:  20667343     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is no accepted consensus on the definition of high-risk patients who may benefit from the use of intraaortic balloon pump (IABP) in coronary artery bypass grafting (CABG). The aim of this study was to develop a risk model to identify high-risk patients and predict the need for IABP insertion during CABG.
METHODS: From April 1996 to December 2006, 8,872 consecutive patients underwent isolated CABG; of these 182 patients (2.1%) received intraoperative or postoperative IABP. The scoring risk model was developed in 4,575 patients (derivation dataset) and validated on the remaining patients (validation dataset). Predictive accuracy was evaluated by the area under the receiver operating characteristic curve.
RESULTS: Mortality was 1% in the entire cohort and 18.7% (22 patients) in the group which received IABP. Multivariable analysis showed that age greater than 70 years, moderate and poor left ventricular dysfunction, previous cardiac surgery, emergency operation, left main disease, Canadian Cardiovascular Society 3-4 class, and recent myocardial infarction were independent risk factors for the need of IABP insertion. Three risk groups were identified. The observed probability of receiving IABP and mortality in the validation dataset was 36.4% and 10% in the high-risk group (score >14), 10.9% and 2.8% in the medium-risk group (score 7 to 13), and 1.7% and 0.7% in the low-risk group (score 0 to 6).
CONCLUSIONS: This simple clinical risk model based on preoperative clinical data can be used to identify high-risk patients who may benefit from elective insertion of IABP during CABG.
Authors:
Antonio Miceli; Simon M J Duggan; Radek Capoun; Francesco Romeo; Massimo Caputo; Gianni D Angelini
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-29     Completed Date:  2010-08-24     Revised Date:  2013-03-11    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  522-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
The Bristol Heart Institute, University of Bristol, Bristol, United Kingdom. antoniomiceli79@alice.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Coronary Artery Bypass*
Female
Forecasting
Humans
Intra-Aortic Balloon Pumping / utilization*
Male
Models, Statistical*
Retrospective Studies
Risk Assessment
Grant Support
ID/Acronym/Agency:
PG/04/079/17372//British Heart Foundation; //British Heart Foundation
Comments/Corrections
Comment In:
Ann Thorac Surg. 2010 Aug;90(2):526-7   [PMID:  20667344 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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