title: Risk factors for hospital mortality in valve replacement with porcine bioprosthesis at an universitary institution.
abstract: OBJECTIVE
  Study designed to identify characteristics of patients related to increased hospital mortality after valve replacement, assumed as risk factors.
  
  
  METHODS
  Retrospective study including 808 patients submitted to the implant of St. Jude Biocor porcine bioprosthesis between 1994 and 2009 at Instituto de Cardiologia do Rio Grande do Sul. Primary outcome was hospital death and hospital mortality was related to demographic and surgical characteristics. Statistics include t-test, qui-square test and logistical regression analysis.
  
  
  RESULTS
  There were 80 (9.9%) hospital deaths. Risk factors identified with univariable logistical analysis (and respective odds-ratio) were: tricuspid surgery (OR 6.11); mitral valve replacement (OR 3.98); left ventricular ejection fraction < 30% (OR 3.82); diabetes mellitus (OR 2.55); atrial fibrillation (OR 2.32); pulmonary arterial hypertension (OR 2.30); serum creatinine > 1,4 mg/dL (OR 2.28); previous cardiac surgery (OR 2.17); systemic arterial hypertension (OR 1.93); functional class III e IV (OR 1.92); coronary bypass (OR 1.81); age > 70 years-old (OR 1.80); congestive heart failure (OR 1.73); e female gender (OR 1.68). Multivariable logistic regression for independent factors identified preponderant risk factors mitral valve replacement (OR 5,29); tricuspid surgery (OR 3.07); diabetes mellitus (OR 2.72); age > 70 years-old (OR 2.62); coronary bypass (OR 2.43); previous cardiac surgery (OR 1.82); e systemic arterial hypertension (OR 1.79).
  
  
  CONCLUSIONS
  Mortality rate is within values found in literature. Identification of risk factors could contribute to changes in surgical indication and medical management in order to reduce hospital mortality.
authors.affiliation: Institute of Cardiology of Rio Grande do Sul / University Cardiology Foundation. Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Ana Carolina Tieppo
authors.initials: AC
authors.lastname: Fornari
authors.forename: Luís Henrique Tieppo
authors.initials: LH
authors.lastname: Fornari
authors.forename: Juan Victor Piccoli Soto
authors.initials: JV
authors.lastname: Paiva
authors.forename: Pauline Elias
authors.initials: PE
authors.lastname: Josende
authors.forename: João Ricardo Michelin
authors.initials: JR
authors.lastname: Sant'anna
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Prates
authors.forename: Renato A K
authors.initials: RA
authors.lastname: Kalil
authors.forename: Ivo A
authors.initials: IA
authors.lastname: Nesralla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects*; D004812:Epidemiologic Methods; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D012307:Risk Factors; D013552:Swine; D014495:Universities; D055815:Young Adult