A Risk Score to Predict 30-Day Mortality in Patients with Intra-Aortic Balloon Pump Implantation

Saeed, Diyar; El-Banayosy, A; Zittermann, Armin; Fritzsche, Dirk; Mirow, Nikolas; Morshuis, Michiel; Köerfer, Reiner

doi:10.1055/s-2006-955879

Cited by 5 publications

(8 citation statements)

References 11 publications

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“…Efforts to establish a scoring system designed for patients with an IABP-support due to LOS after cardiac surgery have already been made by others to know who would need a further therapy escalation with an ECMO or a VAD, as already depicted in the introduction. We consider that scoring systems based on early postoperative hemodynamic parameters as reported by two German large volume centers, the German Heart Center Berlin Group [ 4 ] and Bad Oeyenhausen Group [ 5 ], are particularly reliable scoring systems to detect such patients. One remarkable disadvantage of these two scoring systems is; however, that they are not designed to be applied on patients who are initially stable on a marginal level with an IABP-support and moderate or high dose of inotropic support.…”

Section: Discussionmentioning

confidence: 99%

“…Intraaortic balloon pumping (IABP) is now the most commonly used mechanical assist device for postcardiotomy low output syndrome (LOS) [ 1 ]. There have been some efforts in the past to predict the prognosis in this patient cohort [ 2 – 6 ], including the introduction of scoring systems reported from two German large volume centers, the German Heart Center Berlin group [ 4 ] and Bad Oeyenhausen group [ 5 ]. The aim of previous efforts was focused on the identification of patients who would benefit from further aggressive therapy, e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, those reports only considered acute parameters (serum lactate level, hemodynamics, mixed venous saturation, and adrenaline dose) obtained 1–6 h after surgery. In contrast, preoperative patient characteristics, intraoperative parameters and postoperative complications were not analyzed by those reports [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Outcome analysis for prediction of early and long-term survival in patients receiving intra-aortic balloon pumping after cardiac surgery

Kamiya

Schilling

Akhyari

et al. 2016

Gen Thorac Cardiovasc Surg

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BackgroundPatients requiring an intra-aortic balloon pump (IABP) after cardiac surgery are critically ill and need a prolonged ICU stay. Considering limited health care resources, the early identification of patients with an extremely poor prognosis is important as a solid base for the decision whether further aggressive continuation or cessation of the therapy is recommendable.MethodsFrom 2001 to 2007, 552 patients with low-output syndrome after open-heart surgery and IABP implantation in OR or within 24 h thereafter on ICU were retrospectively analyzed.ResultsThe overall mortality at 30 and 180-day were 31 and 40 %, respectively. According to multivariate analyses, following factors were used to generate an IABP score: female gender, age ≥70 years, simultaneous coronary and valve surgery, aortic cross-clamp time >120 min., need of norepinephrin more than 0.4 µg kg−1 min−1, postoperative dialysis, and maximal serum creatinine kinase >3000 mg mL−1. The 30-day mortality continuously increased along the score (10.1 % for score = 0, n = 98; 11.8 % for score = 1, n = 144; 27.5 % for score = 2, n = 153; 40.4 % score = 3, n = 89; 65.2 % for score = 4, n = 46; 77.8 % for score = 5, n = 27) and reached 100 % for all patients with a score of 6 (n = 4).ConclusionsPrediction of 30 days mortality was possible with our scoring system based on multivariate analysis, and patients with scores of 4 or greater had remarkably worse early and late survival.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcome analysis for prediction of early and long-term survival in patients receiving intra-aortic balloon pumping after cardiac surgery

Kamiya

Schilling

Akhyari

et al. 2016

Gen Thorac Cardiovasc Surg

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“…The parameters that make up this score are the needs of adrenaline, maximum urine output in diuretic therapy, mixed venous oxygen saturation and left atrial pressure. Another score for the same purpose was proposed by Saeed et al [26], which, after six hours of implantation of the IABP has the power to predict survival at 30 days from the mean arterial pressure, epinephrine dose, central venous pressure and serum lactate concentration.…”

Section: Discussionmentioning

confidence: 99%

Use of intra-aortic balloon pump in cardiac surgery: analysis of 80 consecutive cases

Júnior¹,

Tagliari²,

Luvizetto³

et al. 2012

Rev Bras Cir Cardiovasc

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Background:The low cardiac output syndrome in perioperative period of cardiac surgery may occur in about 10 to 15% of patients; of this total, 2% require mechanical support for adequate hemodynamic control.Objective: This study aimed to describe the mortality of patients requiring intra-aortic balloon pump (IABP) in transor post-cardiac surgery, identifying preoperative variables associated with a worse outcome, as well as describe the postoperative complications and survival in the medium term. Patients and Methods: retrospective cohort study including 80 consecutive cases between January/2009 and September/ 2011. The patients had on average 62.9 ± 11.3 years and 58.8% were male. In the sample, 81.3% were hypertensive, 50% had previous myocardial infarction and 38.8% heart failure NYHA III/IV. The most common surgery performed was isolated coronary artery bypass grafting (37.5%).Results: Hospital mortality was 53.8% (95% HF: 42.7-64.9) and the cross-clamp time >90 minutes was an independent predictor of mortality in multivariate analysis (RR 1.52 95% HF: 1.04-2.22). Regarding complications, 71.3% (95% HF: 61.2 to 81.4) of patients had at least one additional complication: the lower limb ischemia was observed in 5.0% of patients. The 1-year survival was 43.6%, observing a plateau in the survival rate after an initial sharp drop, related to hospital mortality.Conclusion: Patients who need the IABP form a group of very high risk for morbidity and mortality. Its use, however, allows many patients to recover an evolution that was invariably fatal, having the patients discharged home a good survival in the medium term.Descriptors: Intra-aortic balloon pumping. Cardiac surgical procedures. Cardiac output, low. ResumoFundamento: A síndrome de baixo débito cardíaco no perioperatório de cirurgia cardíaca pode incidir em cerca de 10 a 15% dos pacientes; desse total, 2% necessitam de suporte mecânico para adequado controle hemodinâmico.Objetivos: Descrever a mortalidade de pacientes que necessitaram utilizar balão intra-aórtico (BIAo) no trans ou pós-operatório de cirurgia cardíaca, identificando variáveis pré-operatórias associadas a pior desfecho, assim como descrever as complicações pós-operatórias e a sobrevida em médio prazo. Rev Bras Cir Cardiovasc 2012;27(2):251-9

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“…Although there exist some data to suggest that certain patients will expire without extracorporeal support, such as the intraaortic balloon pump score, predictors of survival aft er VA ECMO in the adult population are lacking. 29 Overall survival for adult VA support from the 2014 ELSO registry is 40% and from extracorporeal cardiopulmonary resuscitation, 29%.…”

Section: Cardiac Supportmentioning

confidence: 99%

Clinical and Billing Review of Extracorporeal Membrane Oxygenation

Blum

Lynch

Coopersmith

2015

Chest

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A Risk Score to Predict 30-Day Mortality in Patients with Intra-Aortic Balloon Pump Implantation

Abstract: Our data demonstrate that a score can predict 30-day mortality in patients with IABP implantation. Such a score can be useful to find out whether or not ECMO/VAD implantation is necessary.

Cited by 5 publications

References 11 publications

Outcome analysis for prediction of early and long-term survival in patients receiving intra-aortic balloon pumping after cardiac surgery

Outcome analysis for prediction of early and long-term survival in patients receiving intra-aortic balloon pumping after cardiac surgery

Use of intra-aortic balloon pump in cardiac surgery: analysis of 80 consecutive cases

Clinical and Billing Review of Extracorporeal Membrane Oxygenation

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