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

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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.	王金帅, 杨思远. SinoSCORE、EuroSCORE Ⅱ、STS 的临床应用回顾及发展现状. 医学综述, 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.	仓正强, 魏渝鉴, 张杨杨. EuroSCORE 临床应用回顾和展望. 中国胸心血管外科临床杂志, 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, 高长青, 肖苍松, 等. Logistic EuroSCORE 与 EuroSCOREⅡ 风险评分系统对冠状动脉旁路移植术后死亡风险预测的比较. 医学研究杂志, 2014, 43(5): 34-36.
10.	江慧琦, 王萌, 张书铭, 等. 比较 additive EuroSCORE, logistic EuroSCORE, EuroSCORE Ⅱ风险评分系统在评估中国心脏外科手术患者中的应用. 岭南现代临床外科, 2013, 13(6): 485-489.
11.	金磊, 王崇, 李白翎, 等. EuroSCORE Ⅱ模型对瓣膜手术患者在院死亡风险预测的评价. 第二军医大学学报, 2013, 34(5): 536-540.
12.	李梁钢, 姜胜利, 任崇雷, 等. 第二版欧洲心脏手术风险评估系统模型对主动脉瓣置换手术患者在院死亡风险预测的评价. 中国体外循环杂志, 2014, 12(2): 110-112.
13.	孟凡琦, 宋世波, 林智, 等. EuroSCOREⅡ和 STS 评分在感染性心内膜炎手术治疗中的应用价值. 南京医科大学学报(自然科学版), 2017, 37(11): 1423-1428.
14.	代思思, 李曼, 张延荣, 等. 心脏瓣膜手术术后心律失常的危险因素与短期预后分析. 临床麻醉学杂志, 2019, 35(4): 352-357.
15.	皮静虹, 陈文敏, 贾政, 等. 瓣膜置换术后早期并发恶性心律失常致患者心脏骤停. 昆明医科大学学报, 2017, 38(10): 55-59.

1. 王金帅, 杨思远. SinoSCORE、EuroSCORE Ⅱ、STS 的临床应用回顾及发展现状. 医学综述, 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. 仓正强, 魏渝鉴, 张杨杨. EuroSCORE 临床应用回顾和展望. 中国胸心血管外科临床杂志, 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, 高长青, 肖苍松, 等. Logistic EuroSCORE 与 EuroSCOREⅡ 风险评分系统对冠状动脉旁路移植术后死亡风险预测的比较. 医学研究杂志, 2014, 43(5): 34-36.
10. 江慧琦, 王萌, 张书铭, 等. 比较 additive EuroSCORE, logistic EuroSCORE, EuroSCORE Ⅱ风险评分系统在评估中国心脏外科手术患者中的应用. 岭南现代临床外科, 2013, 13(6): 485-489.
11. 金磊, 王崇, 李白翎, 等. EuroSCORE Ⅱ模型对瓣膜手术患者在院死亡风险预测的评价. 第二军医大学学报, 2013, 34(5): 536-540.
12. 李梁钢, 姜胜利, 任崇雷, 等. 第二版欧洲心脏手术风险评估系统模型对主动脉瓣置换手术患者在院死亡风险预测的评价. 中国体外循环杂志, 2014, 12(2): 110-112.
13. 孟凡琦, 宋世波, 林智, 等. EuroSCOREⅡ和 STS 评分在感染性心内膜炎手术治疗中的应用价值. 南京医科大学学报(自然科学版), 2017, 37(11): 1423-1428.
14. 代思思, 李曼, 张延荣, 等. 心脏瓣膜手术术后心律失常的危险因素与短期预后分析. 临床麻醉学杂志, 2019, 35(4): 352-357.
15. 皮静虹, 陈文敏, 贾政, 等. 瓣膜置换术后早期并发恶性心律失常致患者心脏骤停. 昆明医科大学学报, 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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