Document Detail


Influence of timing of intraaortic balloon placement in cardiac surgical patients.
MedLine Citation:
PMID:  19909993     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The study objective was to evaluate the association between timing of intraaortic balloon pump insertion and outcomes in patients undergoing cardiac surgery. METHODS: All patients aged 18 years or more who underwent coronary artery bypass surgery, cardiac valve surgery, or thoracic aortic surgery between January 2002 and December 2007 were included. Data were obtained from cardiac surgery and intensive care databases. Patients were categorized as receiving a preoperative, intraoperative, or postoperative intraaortic balloon pump and compared with a reference group who did not receive an intraaortic balloon pump. Summary and descriptive statistics were used to compare the groups. Logistic regression was used to model in-hospital mortality, and survival methods were used to model time to event data, such as length of stay. RESULTS: There were 7440 patients included over a 6-year period, of whom 217 (2.9%) received a preoperative intraaortic balloon pump, 184 (2.4%) received an intraoperative intraaortic balloon pump, and 42 (0.56%) received a postoperative intraaortic balloon pump. Logistic European System for Cardiac Operative Risk Evaluation-derived predicted risk of death was higher across all intraaortic balloon pump groups compared with the group with no intraaortic balloon pump. Observed in-hospital mortality was significantly lower in the preoperative group (10%) and the group with no intraaortic balloon pump (0.8%) compared with the intraoperative (16%) and postoperative (29%) groups. Risk-adjusted mortality was also lower in the preoperative group. CONCLUSION: This study comparing outcomes in patients undergoing cardiac surgical procedures with timing of intraaortic balloon pump placement revealed that the use of preoperative intraaortic balloon pumps was associated with a strong trend toward reduction in in-hospital mortality despite a higher predicted mortality in this group. The study provides support to the growing body of literature advocating preoperative use of intraaortic balloon pumps in carefully selected patients.
Authors:
Jayshree D Lavana; John F Fraser; Susan E Smith; Lesley Drake; Peter Tesar; Daniel V Mullany
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-11-11
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  140     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  80-5     Citation Subset:  AIM; IM    
Copyright Information:
Crown Copyright 2010. Published by Mosby, Inc. All rights reserved.
Affiliation:
Critical Care Research Group, Department of Intensive Care, The Prince Charles Hospital, Brisbane, Queensland, Australia. jayshree_lavana@health.qld.gov.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Surgical Procedures* / adverse effects,  mortality
Female
Hospital Mortality
Humans
Intensive Care
Intra-Aortic Balloon Pumping* / adverse effects,  mortality
Length of Stay
Logistic Models
Male
Middle Aged
Patient Selection
Respiration, Artificial
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome

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


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