Cause-of-death analysis in low-risk cardiac surgery patients during postoperative period_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Huangshu , QIU Zhibing , XU Ming , HUANG Fuhua , WANG Liming , JIANG Yingshuo , CHEN Wen ,  CHEN Xin

Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Medical School of Southeast University, Nanjing, 210009, P.R.China;

Corresponding?author：

CHEN Xin, Email: stevecx@njmu.edu.cn

Keywords：

Cardiac surgery; death causes; low-risk patients; treatment

DOI：

10.7507/1007-4848.201909046

Video：

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Objective To analyze the cause of death in low-risk cardiac surgery patients during postoperative period and discuss the prevention and treatment methods to increase the survival rate.Methods We retrospectively analyzed the clinical data of 132 patients dead after cardiac surgery from January 2014 to December 2018, among whom 35 patients had a EuroSCORE Ⅱ score <4% (low-risk cardiac surgery patients), including 20 males and 15 females aged 62.7±13.4 years. The cause of death in these low-risk patients was analyzed.Results The main causes of death were cardiogenic and brain-derived causes (60.0%), and infections and ogran failure (45.7%). Pulmonary infection and low cardiac output after surgery were the main causes of death. Cerebral infarction, malignant arrhythmia and multiple organ failure were the common causes of death. There were 4 deaths (11.4%) caused by accidents, including gastrointestinal bleeding caused by esophageal ultrasound probe, cough and asphyxia caused by drinking water, postoperative paralytic ileus and multiple perioperative allergic reactions caused by allergic constitution.Conclusion Postoperative treatment and prevention for low-risk cardiac surgery patients should be focused on postoperative infection, and cardiac and brain function protection. Changes in various organ functions need to be closely monitored for preventing organ failure, accidents should be strictly controlled, and more details of intraoperative and postoperative treatment still need to be further improved.

Citation： LI Huangshu, QIU Zhibing, XU Ming, HUANG Fuhua, WANG Liming, JIANG Yingshuo, CHEN Wen, CHEN Xin. Cause-of-death analysis in low-risk cardiac surgery patients during postoperative period. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(7): 758-761. doi: 10.7507/1007-4848.201909046 Copy

1.	王金帥, 楊思遠. SinoSCORE、EuroSCORE Ⅱ、STS 的臨床應用回顧及發展現狀. 醫學綜述, 2019, 25(5): 939-945.
2.	Nashef SA, Roques F, Sharples LD, et al. EuroSCOREⅡ. Eur J Cardiothorac Surg, 2012, 41(4): 734-744.
3.	倉正強, 魏渝鑒, 張楊楊. EuroSCORE 臨床應用回顧和展望. 中國胸心血管外科臨床雜志, 2016, 23(10): 1012-1018.
4.	Rosato S, Santini F, Barbanti M, et al. Transcatheter aortic valve implantation compared with surgical aortic valve replacement in low-risk patients. Circ Cardiovasc Interv, 2016, 9(5): e003326.
5.	Nicolas W, Ralf Z, Andreas B, et al. Patients at intermediate surgical risk undergoing isolated interventional or surgical aortic valve implantation for severe symptomatic aortic valve stenosis. Circulation, 2018, 138(23): 2611-2623.
6.	Graham I, Atar D, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur Heart J, 2007, 28(19): 2375-2414.
7.	Barili F, Pacini D, Capo A, et al. Does EuroSCOREⅡperform better than its original versions? A multicentre validation study. Eur Heart J, 2013, 34(1): 22-29.
8.	Biancari F, Vasques F, Mikkola R, et al. Validation of EuroSCOREⅡin patients undergoing coronary artery bypass surgery. Ann Torac Surg, 2012, 93(6): 1930-1935.
9.	王肇, 高長青, 肖蒼松, 等. Logistic EuroSCORE 與 EuroSCOREⅡ 風險評分系統對冠狀動脈旁路移植術后死亡風險預測的比較. 醫學研究雜志, 2014, 43(5): 34-36.
10.	江慧琦, 王萌, 張書銘, 等. 比較 additive EuroSCORE, logistic EuroSCORE, EuroSCORE Ⅱ風險評分系統在評估中國心臟外科手術患者中的應用. 嶺南現代臨床外科, 2013, 13(6): 485-489.
11.	金磊, 王崇, 李白翎, 等. EuroSCORE Ⅱ模型對瓣膜手術患者在院死亡風險預測的評價. 第二軍醫大學學報, 2013, 34(5): 536-540.
12.	李梁鋼, 姜勝利, 任崇雷, 等. 第二版歐洲心臟手術風險評估系統模型對主動脈瓣置換手術患者在院死亡風險預測的評價. 中國體外循環雜志, 2014, 12(2): 110-112.
13.	孟凡琦, 宋世波, 林智, 等. EuroSCOREⅡ和 STS 評分在感染性心內膜炎手術治療中的應用價值. 南京醫科大學學報(自然科學版), 2017, 37(11): 1423-1428.
14.	代思思, 李曼, 張延榮, 等. 心臟瓣膜手術術后心律失常的危險因素與短期預后分析. 臨床麻醉學雜志, 2019, 35(4): 352-357.
15.	皮靜虹, 陳文敏, 賈政, 等. 瓣膜置換術后早期并發惡性心律失常致患者心臟驟停. 昆明醫科大學學報, 2017, 38(10): 55-59.

1. 王金帥, 楊思遠. SinoSCORE、EuroSCORE Ⅱ、STS 的臨床應用回顧及發展現狀. 醫學綜述, 2019, 25(5): 939-945.
2. Nashef SA, Roques F, Sharples LD, et al. EuroSCOREⅡ. Eur J Cardiothorac Surg, 2012, 41(4): 734-744.
3. 倉正強, 魏渝鑒, 張楊楊. EuroSCORE 臨床應用回顧和展望. 中國胸心血管外科臨床雜志, 2016, 23(10): 1012-1018.
4. Rosato S, Santini F, Barbanti M, et al. Transcatheter aortic valve implantation compared with surgical aortic valve replacement in low-risk patients. Circ Cardiovasc Interv, 2016, 9(5): e003326.
5. Nicolas W, Ralf Z, Andreas B, et al. Patients at intermediate surgical risk undergoing isolated interventional or surgical aortic valve implantation for severe symptomatic aortic valve stenosis. Circulation, 2018, 138(23): 2611-2623.
6. Graham I, Atar D, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur Heart J, 2007, 28(19): 2375-2414.
7. Barili F, Pacini D, Capo A, et al. Does EuroSCOREⅡperform better than its original versions? A multicentre validation study. Eur Heart J, 2013, 34(1): 22-29.
8. Biancari F, Vasques F, Mikkola R, et al. Validation of EuroSCOREⅡin patients undergoing coronary artery bypass surgery. Ann Torac Surg, 2012, 93(6): 1930-1935.
9. 王肇, 高長青, 肖蒼松, 等. Logistic EuroSCORE 與 EuroSCOREⅡ 風險評分系統對冠狀動脈旁路移植術后死亡風險預測的比較. 醫學研究雜志, 2014, 43(5): 34-36.
10. 江慧琦, 王萌, 張書銘, 等. 比較 additive EuroSCORE, logistic EuroSCORE, EuroSCORE Ⅱ風險評分系統在評估中國心臟外科手術患者中的應用. 嶺南現代臨床外科, 2013, 13(6): 485-489.
11. 金磊, 王崇, 李白翎, 等. EuroSCORE Ⅱ模型對瓣膜手術患者在院死亡風險預測的評價. 第二軍醫大學學報, 2013, 34(5): 536-540.
12. 李梁鋼, 姜勝利, 任崇雷, 等. 第二版歐洲心臟手術風險評估系統模型對主動脈瓣置換手術患者在院死亡風險預測的評價. 中國體外循環雜志, 2014, 12(2): 110-112.
13. 孟凡琦, 宋世波, 林智, 等. EuroSCOREⅡ和 STS 評分在感染性心內膜炎手術治療中的應用價值. 南京醫科大學學報(自然科學版), 2017, 37(11): 1423-1428.
14. 代思思, 李曼, 張延榮, 等. 心臟瓣膜手術術后心律失常的危險因素與短期預后分析. 臨床麻醉學雜志, 2019, 35(4): 352-357.
15. 皮靜虹, 陳文敏, 賈政, 等. 瓣膜置換術后早期并發惡性心律失常致患者心臟驟停. 昆明醫科大學學報, 2017, 38(10): 55-59.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Cause-of-death analysis in low-risk cardiac surgery patients during postoperative period

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