title: Multivariate analysis of risk factors for hospital mortality in valvular reoperations for prosthetic valve dysfunction.
abstract: OBJECTIVE
  The purpose of the study was to analyze risk factors for hospital mortality in patients undergoing valvular reoperations for prosthetic valve dysfunction.
  
  
  METHODS
  We performed a prospective analysis of 146 patients who underwent valvular reoperations for prosthetic valve dysfunction between July 1995 and June 1999 at the Heart Institute of the University of São Paulo Medical School. Multivariate statistical analysis with logistic regression was used to analyze preoperative and intraoperative variables to determine risk factors for hospital mortality.
  
  
  RESULTS
  The overall hospital mortality was 10.9% (16 patients). Univariate analysis showed that the following variables were associated with higher mortality rates: advanced New York Heart Association (NYHA) functional class, increased creatinine level, prolonged extracorporeal circulation time and treatment of annular abscess. Logistic multivariate analysis identified advanced NYHA functional class and a creatinine level higher than 1.5 mg/dl as independent predictors of hospital mortality.
  
  
  CONCLUSIONS
  Advanced NYHA functional class and higher creatinine levels were independent predictors of hospital mortality in patients submitted for valvular reoperations for prosthetic valve dysfunction.
authors.affiliation: InCor-Heart Institute, University of São Paulo Medical School, São Paulo, Brazil. carlos.brandao@incor.usp.br
authors.forename: Carlos Manuel
authors.initials: CM
authors.lastname: de Almeida Brandão
authors.forename: Pablo Maria Alberto
authors.initials: PM
authors.lastname: Pomerantzeff
authors.forename: Luciano Rapold
authors.initials: LR
authors.lastname: Souza
authors.forename: Flávio
authors.initials: F
authors.lastname: Tarasoutchi
authors.forename: Max
authors.initials: M
authors.lastname: Grimberg
authors.forename: José Antonio Franchini
authors.initials: JA
authors.lastname: Ramires
authors.forename: Sérgio
authors.initials: S
authors.lastname: Almeida de Oliveira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003404:Creatinine / Q000097:blood; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011475:Prosthesis Failure; D012086:Reoperation / Q000401:mortality; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D003404:Creatinine