Fatores de risco para mortalidade em revasculariza??o do mioc?rdio de urg?ncia e emerg?ncia

• Main Author: Carvalho, Sidiclei Machado
• Other Authors: Bodanese, Luiz Carlos
• Format: Others
• Language: Portuguese
• Published: Pontif?cia Universidade Cat?lica do Rio Grande do Sul 2015
• Subjects: MEDICINA; CIRURGIA TOR?CICA; CARDIOPATIAS; REVASCULARIZA??O MIOC?RDICA; MORTALIDADE; FATORES DE RISCO; CIENCIAS DA SAUDE::MEDICINA
• Online Access: http://tede2.pucrs.br/tede2/handle/tede/6445

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS ([e-mail]) on 2015-12-28T17:28:07Z No. of bitstreams: 1 476880 - Texto Completo.pdf: 599451 bytes, checksum: cd9bc0981219eb2d393eed6f52e56c65 (MD5) === Made available in DSpace on 2015-12-28T17:28:07Z (GMT). No. of bitstreams: 1 476880 - Texto Completo.pdf: 599451 bytes, checksum: cd9bc0981219eb2d393eed6f52e56c65 (MD5) Previous issue date: 2015-03-27 === Objectives: To identify the variables related to morbidity and risk factors for death of patients that undergo to urgent myocardial revascularization surgery. Method: Historical cross sectional study. It included 232 patients aged ?18 years old that underwent to isolated myocardial revascularization surgery, with or without cardiopulmonary bypass. Those surgeries were urgents and were adopted as emergency measures. It happened from January 1996 to December 2014. The total of revascularization myocardial surgeries carried out in this period were 3772 Results: The frequency of death observed in this sample was 117 (50.4%). Multivariate analysis identified as risk predictors: age ?65 years old (OR: 2.34; 95% CI 1.35 to 5.27; P = 0.007), congestive heart failure class III and IV (OR: 2, 67, 95% CI 1.35 to 5.28; P = 0.005), cardiopulmonary bypass time> 90 minutes (OR: 2.52, 95% CI 1.21 to 4.17; P = 0.001), cardiogenic shock (OR: 3.47; 95% CI 1.70 to 7.07; P = 0.001), acute myocardial infarction (OR: 2.73, 95% CI 1.25 to 5.94, P = 0.011), bleeding (OR: 3.06, 95% CI 1.00 to 9.37; P = 0.049). Conclusion: Age, chronic obstructive pulmonary disease, class III and IV of congestive heart failure, cardiopulmonary bypass time, cardiogenic shock, acute myocardial infarction and bleeding they were independent predictors of in-hospital mortality in patients that undergo to myocardial revascularization surgery. === Objetivos: identificar as vari?veis relacionadas ? morbidade e os fatores de risco para o ?bito de pacientes submetidos ? revasculariza??o do mioc?rdio de urg?ncia e emerg?ncia. M?todos: Estudo de coorte hist?rica. Inclu?dos 232 pacientes com idade ?18 anos, submetidos ? cirurgia de revasculariza??o do mioc?rdio isolada, com ou sem uso de circula??o extracorp?rea, em car?ter de urg?ncia e emerg?ncia, de janeiro de 1996 a dezembro de 2014, de um total de 3772 cirurgias de revasculariza??o do mioc?rdio realizadas neste per?odo. Resultados: A frequ?ncia de ?bito observada nesta amostra foi de 50,4% (117 pacientes). A an?lise multivariada identificou como preditores de risco para mortalidade: idade maior que 65 anos (OR: 2,35; IC 95% 1,27?4,35; P= 0,007), insufici?ncia card?aca congestiva classe III e IV (OR: 2,67, IC 95% 1,36?5,28; P= 0,005), doen?a pulmonar obstrutiva cr?nica (OR: 2,49; IC 95% 1,21?5,11; P=0,013) e tempo de circula??o extracorp?rea maior que 90 minutos (OR: 2,52, IC 95% 1,22?4,17; P= 0,010). Conclus?o: Idade, doen?a pulmonar obstrutiva cr?nica, classe III e IV da insufici?ncia card?aca congestiva, tempo de circula??o extracorp?rea, foram preditores independentes de mortalidade intra-hospitalar de pacientes submetidos ? cirurgia de revasculariza??o do mioc?rdio de urg?ncia e de emerg?ncia.