Long-term relative survival after primary heart valve replacement1

Ståhle, Elisabeth; Kvidal, Per; So, Nyström; Bergström, Reinhold

doi:10.1016/s1010-7940(96)01025-1

Cited by 22 publications

(13 citation statements)

References 19 publications

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“…Despite an increasing trend of more comorbid and complex patients being referred to cardiac surgery, long-term survival remained unchanged throughout the study period. Furthermore, patients undergoing cardiac surgery in Trondheim also showed similar and even somewhat improved observed and relative survival rates compared to older reports from other centres [ 15 , 16 ].…”

Section: Discussionsupporting

confidence: 71%

Reduced Long-Term Relative Survival in Females and Younger Adults Undergoing Cardiac Surgery: A Prospective Cohort Study

et al. 2016

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ObjectivesTo assess long-term survival and mortality in adult cardiac surgery patients.Methods8,564 consecutive patients undergoing cardiac surgery in Trondheim, Norway from 2000 until censoring 31.12.2014 were prospectively followed. Observed long-term mortality following surgery was compared to the expected mortality in the Norwegian population, matched on gender, age and calendar year. This enabled assessment of relative survival (observed/expected survival rates) and relative mortality (observed/expected deaths). Long-term mortality was compared across gender, age and surgical procedure. Predictors of reduced survival were assessed with multivariate analyses of observed and relative mortality.ResultsDuring follow-up (median 6.4 years), 2,044 patients (23.9%) died. The observed 30-day, 1-, 3- and 5-year mortality rates were 2.2%, 4.4%, 8.2% and 13.8%, respectively, and remained constant throughout the study period. Comparing observed mortality to that expected in a matched sample from the general population, patients undergoing cardiac surgery showed excellent survival throughout the first seven years of follow-up (relative survival ≥ 1). Subsequently, survival decreased, which was more pronounced in females and patients undergoing other procedures than isolated coronary artery bypass grafting (CABG). Relative mortality was higher in younger age groups, females and patients undergoing aortic valve replacement (AVR). The female survival advantage in the general population was obliterated (relative mortality ratio (RMR) 1.35 (1.19–1.54), p<0.001). Increasing observed long-term mortality seen with ageing was due to population risk, and younger age was independently associated with increased relative mortality (RMR per 5 years 0.81 (0.79–0.84), p<0.001)).ConclusionsCardiac surgery patients showed comparable survival to that expected in the general Norwegian population, underlining the benefits of cardiac surgery in appropriately selected patients. The beneficial effect lasted shorter in younger patients, females and patients undergoing AVR or other procedures than isolated CABG. Thus, the study identified three groups that need increased attention for further improvement of outcomes.

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Section: Discussionsupporting

confidence: 71%

Reduced Long-Term Relative Survival in Females and Younger Adults Undergoing Cardiac Surgery: A Prospective Cohort Study

et al. 2016

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“…In our study, the ASA scores were higher in patients with valve replacement surgery than in patients with other types of open heart surgery. In addition, even in the absence of any complication, the expected mortality rates of 5% with valve replacement surgery and 10% with combined CABG and valve replacement surgery are higher than the 2% when CABG surgery only is performed [ 21 ]. Forty percent of our patients with valve replacement surgery underwent simultaneous CABG.…”

Section: Discussionmentioning

confidence: 99%

Methicillin-Resistant <b><i>Staphylococcus aureus </i></b>Infection: An Independent Risk Factor for Mortality in Patients with Poststernotomy Mediastinitis

Yavuz

Şensoy²,

Çeken³

et al. 2014

Med Princ Pract

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Objective: The mortality rate of patients with poststernotomy mediastinitis remains very high. The aim of this study was to identify the risk factors associated with mortality in these patients. Subjects and Methods: Surveillance of sternal surgical-site infections including mediastinitis was carried out for adult patients undergoing a sternotomy between 2004 and 2012. Criteria from the US Centers for Disease Control and Prevention were used to make the diagnosis. All data on patients with a diagnosis of mediastinitis who were included in the study and on mortality risk factors were obtained from the hospital database and then analyzed using SPPS 16.0 for Windows. Results: Of the 19,767 patients undergoing open heart surgery, 117 (0.39%) had poststernotomy mediastinitis; 32% of these 117 died. The independent risk factors for mortality were methicillin-resistant Staphylococcus aureus (MRSA) [odds ratio (OR) 12.11 and 95% confidence interval (CI) 3.15-46.47], intensive-care unit stays >48 h after the first operation (OR 11.21 and 95% CI 3.24-38.84) and surgery that included valve replacement (OR 6.2 and 95% CI 1.44-27.13). The mortality rate decreased significantly, dropping from 38% (34/89) between 2004 and 2008 to 14% (4/28) between 2009 and 2012 (p = 0.018). Conclusion: In this study, elimination of MRSA from the hospital setting decreased the rate of mortality in patients with poststernotomy mediastinitis.

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“…The model's user-friendly input interface permits addition and change of data when required. Many other patient-and surgery-related factors have been shown to influence overall survival after AVR [24,25]. However, at present, the model calculates outcome for an average risk profile only.…”

Section: Limitations Of This Methodologymentioning

confidence: 99%

Comparison of Carpentier-Edwards pericardial and supraannular bioprostheses in aortic valve replacement

Puvimanasinghe

Takkenberg

Eijkemans

et al. 2006

European Journal of Cardio-Thoracic Surgery

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Long-term relative survival after primary heart valve replacement1

Cited by 22 publications

References 19 publications

Reduced Long-Term Relative Survival in Females and Younger Adults Undergoing Cardiac Surgery: A Prospective Cohort Study

Reduced Long-Term Relative Survival in Females and Younger Adults Undergoing Cardiac Surgery: A Prospective Cohort Study

Methicillin-Resistant <b><i>Staphylococcus aureus </i></b>Infection: An Independent Risk Factor for Mortality in Patients with Poststernotomy Mediastinitis

Comparison of Carpentier-Edwards pericardial and supraannular bioprostheses in aortic valve replacement

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