Açık kalp cerrahisi sonrası ıntraaortik balon pompası kullanılan hastalarda hastane mortalitesinde risk faktörleri

Year 2005, Volume: 12 Issue: 1, 11 - 16, 03.04.2009

İlker Kiriş

Abstract

SüleymanDemirel Üniversitesi
TIP FAKÜLTESİ DERGİSİ: 2005 Mart; 12(1)


Açık kalp cerrahisi sonrası ıntraaortik balon pompası kullanılan hastalarda hastane mortalitesinde risk faktörleri


İlker Kiriş



Özet:

Intraaortik balon pompası (IABP), açık kalp cerrahisinde sık kullanılan, geçici dolaşımsal destek sağlayan mekanik bir cihazdır. Başlıca endikasyonları; kardiyojenik şok, kontrol edilemeyen miyokardiyal iskemik ağrı ve postkardiyotomi düşük kardiyak output durumudur. Bu retrospektif çalışmanın amacı, kliniğimizde açık kalp ameliyatı sonrasında IABP kullanılan hastalarda hastane mortalitesi için olası risk faktörlerini araştırmaktı. Kliniğimizde, Temmuz 2002-Haziran 2004 arasında, açık kalp ameliyatı sonrasında IABP kullanılan toplam 52 hasta çalışmaya alındı. Hastaların 42'si erkek (% 80.76), 10'u kadın (% 19.23) olup, erkek ve kadın hastaların yaşları sırasıyla ortalama 63.81 ± 10.06 ve 61.00 ± 12.42 (tüm hastaların ortalama yaşı 63.2 ± 10.4) idi. Eksitus olan hastalar (grup 1, n=20) ve hayatta kalan hastalara (grup 2, n=32) ait parametreler birbiri ile karşılaştırıldığında, diabetes mellitus (p=0.047), kardiyomegali (p=0.004), koroner arter hastalığına eşlik eden kalp kapak hastalığı (p=0.019), obesite (p=0.049), perfüzyon süresi (p= 0.00) ve aortik kros klemp süresi (p=0.026) değerleri açısından istatistiksel olarak anlamlı fark bulundu. Çalışmamız göstermiştir ki; açık kalp cerrahisi sonrası IABP kullanılan hastalarda, diabetes mellitus, kardiyomegali, koroner arter hastalığına eşlik eden kalp kapak hastalığı, obesite, uzamış perfüzyon süresi ve aortik kros klemp süresi, artmış hastane mortalitesine eşlik eden risk faktörleridir. Açık kalp cerrahisi sonrası IABP kullanılan hastalarda mortalite için önemli risk faktörlerinin açığa çıkarılması amacıyla daha fazla sayıda hastayı kapsayan yeni klinik çalışmaların yapılması uygundur.



Anahtar kelimeler: Intraaortik balon pompası, açık kalp cerrahisi, mortalite, risk faktörleri



Abstract



Risk Factors For Hospital Mortality In Patients Intraaortic Balloon Pump Used Following Open Heart Surgery

Intra-aortic balloon pump (IABP), providing temporary mechanical circulatory support, is a frequently used device in open heart surgery. Its main indications are cardiogenic shock, uncontrolled myocardial ischemic pain and postcardiotomy low cardiac output. The objective of this retrospective study was to determine the possible risk factors for hospital mortality in the patients IABP used following open heart surgery in our clinic. A total of 52 patients who underwent open heart operations between January 2002-June 2004 were included into the study. 42 (80.76 %) and 10 (19.23 %) of the patients were male and female, respectively. Mean age of the all patients was 63.2 ± 10.4 and mean age of the male and female patients was 63.81 ± 10.06 and 61.00 ± 12.42, respectively. When parameters of survived and not-survived patients were compared, there were statistically significant differences including diabetes mellitus (p=0.047), cardiomegaly (p=0.004), concomitant heart valve disease (p=0.019), obesity (p=0.049), perfusion period (p=0.00) and aortic cross clamp time (p=0.026). Our study showed that, diabetes mellitus, cardiomegaly, concomitant heart valve disease, obesity, prolonged perfusion period and aortic cross-clamp time can be associated with increased hospital mortality. New clinic studies with higher number of patients should be done to clarify important risk factors for mortality in patients IABP needed following open heart surgery.



Key words: Intraaortic balloon pumping, open heart surgery, mortality, risk factors

Keywords

Intraaortik balon pompasý, açýk kalp cerrahisi, mortalite, risk faktörleri

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