Multivariate analysis of risk factors for hospital mortality in valvular reoperations for prosthetic valve dysfunction.
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.
de Almeida Brandão
Carlos Manuel
CM
InCor-Heart Institute, University of São Paulo Medical School, São Paulo, Brazil. carlos.brandao@incor.usp.br
Pomerantzeff
Pablo Maria Alberto
PM
Souza
Luciano Rapold
LR
Tarasoutchi
Flávio
F
Grimberg
Max
M
Ramires
José Antonio Franchini
JA
Almeida de Oliveira
Sérgio
S
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
D015415:Biomarkers; D003404:Creatinine