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A National Evaluation of Emergency Cardiac Surgery After Percutaneous Coronary Intervention and Postsurgical Patient Outcomes
- Source :
- The American journal of cardiology. 130
- Publication Year :
- 2020
-
Abstract
- There is limited national data regarding emergency cardiac surgery for complications sustained after percutaneous coronary intervention (PCI). This study aimed to examine emergency cardiac surgery after PCI in England and Wales and postsurgical patient outcomes. We analyzed patients in the British Cardiovascular Intervention Society database who underwent PCI between 2007 and 2014 and compared characteristics and outcomes for patients with and without emergency cardiac surgery. A total of 549,303 patients were included in the analysis and 362 (0.07%) underwent emergency cardiac surgery. There was a modest decline in the annual rate of emergency cardiac surgery from 0.09% to 0.06% between 2007 and 2014. Variables associated with emergency cardiac surgery included receipt of circulatory support (Odds ratio (OR) 39.20 95% confidence interval (CI) 27.75 to 55.36), aortic dissection (OR 28.39 95%CI 14.59 to 55.26), coronary dissection (OR 18.50 95%CI 13.60 to 25.18), coronary perforation (OR 7.86 95%CI 4.27 to 14.46), cardiac tamponade (OR 6.77 95%CI 3.13 to 14.66), and on-site surgical cover (OR 2.15 95%CI 1.56 to 2.97). After adjustments, patients with emergency cardiac surgery were at increased odds of 30-day mortality (OR 4.41 95%CI 2.94 to 6.62) and in-hospital major adverse cardiac and cerebrovascular events (OR 1.63 95%CI 1.07 to 2.48). On site surgical cover was independently associated with increased odds of mortality (OR 1.26 95%CI 1.20 to 1.33) following emergency cardiac surgery. In conclusion, emergency cardiac surgery after PCI is a rarely required procedure and in England and Wales there appears to be a decline in recent years. Patients who underwent emergency cardiac surgery have higher risk of adverse outcomes and longer length of hospital stay.
- Subjects :
- Male
medicine.medical_specialty
Heart Diseases
medicine.medical_treatment
Perforation (oil well)
030204 cardiovascular system & hematology
Q1
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Postoperative Complications
Cardiac tamponade
Internal medicine
Medicine
Humans
030212 general & internal medicine
Cardiac Surgical Procedures
Emergency Treatment
Aged
Aortic dissection
Aged, 80 and over
RD32
Wales
business.industry
Percutaneous coronary intervention
R735
Odds ratio
Middle Aged
medicine.disease
R1
Confidence interval
Cardiac surgery
England
Emergency medicine
Conventional PCI
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
RD
Subjects
Details
- ISSN :
- 18791913
- Volume :
- 130
- Database :
- OpenAIRE
- Journal :
- The American journal of cardiology
- Accession number :
- edsair.doi.dedup.....b7843adedd977e147fb04364304f8a1b