title: Evaluation of variables responsible for hospital mortality in patients with rheumatic heart disease undergoing double valve replacement.
abstract: OBJECTIVE
  To describe the hospital mortality and associated clinical and echocardiographic variables in patients with rheumatic disease who underwent double valve replacement surgery.
  
  
  METHODS
  This is a cross sectional descriptive study of mortality, performed in a referral hospital in Salvador, Bahia. Records from patients with rheumatic disease who underwent double valve replacement surgery during the years 2007-2011 were analyzed.
  
  
  RESULTS
  The studied sample comprises 104 patients and 60 (57.7%) were male. The mean age was 38.04±14.45. Sixty five bioprostheses and 38 mechanical prostheses were used in these patients at the time of surgery. There were statistically significant differences between the two groups, when we analyzed the following variables: the mean age (36.30±13.03 vs. 45.35±17.8 years-old, P=0.011), mean hemoglobin (11.10±2.19 vs. 9.22±2.26 g/dL, P=0.002), mean hematocrit (34.22±5.86 vs. 28.44±6.62%, P<0.001). New York Heart Association functional class III and IV (NYHA) (P=0.022) was statistically associated with mortality.
  
  
  CONCLUSIONS
  We concluded that the mean hemoglobin/hematocrit level and the NYHA functional class was the major variables associated to the mortality among these patients. Based on these data one may concern about the patient best moment for surgery and the patient hemoglobin level.
authors.affiliation: Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: André Maurício Souza
authors.initials: AM
authors.lastname: Fernandes
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
authors.forename: Gustavo Maltez de
authors.initials: GM
authors.lastname: Andrade
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
authors.forename: Rafael Marcelino
authors.initials: RM
authors.lastname: Oliveira
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
authors.forename: Gabriela Tanajura
authors.initials: GT
authors.lastname: Biscaia
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
authors.forename: Francisco Farias Borges dos
authors.initials: FF
authors.lastname: Reis
authors.affiliation: Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Cristiano Ricardo
authors.initials: CR
authors.lastname: Macedo
authors.affiliation: Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Andre Rodrigues
authors.initials: AR
authors.lastname: Durães
authors.affiliation: Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Roque
authors.initials: R
authors.lastname: Aras Junior
mesh_terms: D000328:Adult; D000367:Age Factors; D001938:Brazil; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality*; D006351:Heart Valves / Q000601:surgery*; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006454:Hemoglobins