title: Outcome analysis for prediction of early and long-term survival in patients receiving intra-aortic balloon pumping after cardiac surgery.
abstract: BACKGROUND
  Patients requiring an intra-aortic balloon pump (IABP) after cardiac surgery are critically ill and need a prolonged ICU stay. Considering limited health care resources, the early identification of patients with an extremely poor prognosis is important as a solid base for the decision whether further aggressive continuation or cessation of the therapy is recommendable.
  
  
  METHODS
  From 2001 to 2007, 552 patients with low-output syndrome after open-heart surgery and IABP implantation in OR or within 24 h thereafter on ICU were retrospectively analyzed.
  
  
  RESULTS
  The overall mortality at 30 and 180-day were 31 and 40 %, respectively. According to multivariate analyses, following factors were used to generate an IABP score: female gender, age ≥70 years, simultaneous coronary and valve surgery, aortic cross-clamp time >120 min., need of norepinephrin more than 0.4 µg kg(-1) min(-1), postoperative dialysis, and maximal serum creatinine kinase >3000 mg mL(-1). The 30-day mortality continuously increased along the score (10.1 % for score = 0, n = 98; 11.8 % for score = 1, n = 144; 27.5 % for score = 2, n = 153; 40.4 % score = 3, n = 89; 65.2 % for score = 4, n = 46; 77.8 % for score = 5, n = 27) and reached 100 % for all patients with a score of 6 (n = 4).
  
  
  CONCLUSIONS
  Prediction of 30 days mortality was possible with our scoring system based on multivariate analysis, and patients with scores of 4 or greater had remarkably worse early and late survival.
authors.affiliation: Department of Cardiac Surgery, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa, 078-8510, Japan. hkamiya88@yahoo.co.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kamiya
authors.affiliation: Department of Cardiovascular Surgery, University of Duesseldorf, Moorenstrasse 5, 40225, Düesseldorf, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Schilling
authors.affiliation: Department of Cardiovascular Surgery, University of Duesseldorf, Moorenstrasse 5, 40225, Düesseldorf, Germany.
authors.forename: Payam
authors.initials: P
authors.lastname: Akhyari
authors.affiliation: Department of Cardiac Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Arjang
authors.initials: A
authors.lastname: Ruhparwar
authors.affiliation: Department of Cardiac Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kallenbach
authors.affiliation: Department of Cardiac Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Karck
authors.affiliation: Department of Cardiovascular Surgery, University of Duesseldorf, Moorenstrasse 5, 40225, Düesseldorf, Germany.
authors.forename: Artur
authors.initials: A
authors.lastname: Lichtenberg
mesh_terms: D000368:Aged; D002303:Cardiac Output, Low / Q000209:etiology / Q000628:therapy*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011182:Postoperative Care / Q000379:methods; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Cardiac surgery; Intraaortic balloon pumping; Low output syndrome