Table 2.
Effect of patient characteristics and perioperative management on the occurrence of postcardiotomy ventricular dysfunction
| Preoperative patient characteristics | PCVD | OR | 95% CI | P | |
|---|---|---|---|---|---|
| Yes, n (%) | No, n (%) | ||||
| Age >75 (years) | |||||
| Yes | 38 (40.4) | 56 (59.6) | 2.80 | 1.51-5.19 | <0.001 |
| No | 25 (19.5) | 103 (80.5) | 1.00 | Reference | - |
| Body mass index | |||||
| >21-30 | 40 (28.2) | 102 (71.8) | 1.00 | Reference | - |
| >30 | 18 (25.0) | 54 (75.0) | 0.85 | 0.44-1.93 | 0.623 |
| ≤21 | 5 (62.5) | 3 (37.5) | 4.22 | 0.94-19.12 | 0.040 |
| Sex | |||||
| Male | 43 (28.1) | 110 (71.9) | 1.00 | Reference | - |
| Female | 20 (29.0) | 49 (71.0) | 1.04 | 0.56-1.96 | 0.893 |
| High blood pressure | |||||
| Yes | 59 (28.6) | 147 (71.4) | 1.20 | 0.37-3.90 | 0.756 |
| No | 4 (25.0) | 12 (75.0) | 1.00 | Reference | - |
| Pulmonary hypertension | |||||
| Yes | 10 (45.5) | 12 (54.6) | 2.31 | 0.93-5.71 | 0.062 |
| No | 53 (26.5) | 147 (73.5) | 1.00 | Reference | - |
| Diabetes | |||||
| Yes | 25 (29.8) | 59 (70.2) | 1.12 | 0.61-2.03 | 0.722 |
| No | 38 (27.5) | 100 (72.5) | 1.00 | Reference | - |
| Vascular disease | |||||
| Yes | 25 (26.9) | 68 (73.1) | 0.88 | 0.49-1.60 | 0.675 |
| No | 38 (29.5) | 91 (70.5) | 1.00 | Reference | - |
| Chronic obstructive lung disease | |||||
| Yes | 7 (22.6) | 24 (77.4) | 0.70 | 0.29-1.73 | 0.441 |
| No | 56 (29.3) | 135 (70.7) | 1.00 | Reference | - |
| Karnofsky performance status <50 | |||||
| Yes | 9 (36.0) | 16 (64.0) | 1.49 | 1.69-3.58 | 0.371 |
| No | 54 (27.4) | 143 (72.6) | 1.00 | Reference | - |
| Parsonnet score >22 | |||||
| Yes | 40 (40.8) | 58 (59.2) | 3.03 | 1.62-5.67 | <0.001 |
| No | 23 (18.6) | 101 (81.5) | 1.00 | Reference | - |
| LVEF <40% | |||||
| Yes | 25 (51.0) | 23 (49.0) | 3.70 | 1.85-7.40 | <0.001 |
| No | 38 (22.0) | 135 (78.0) | 1.00 | Reference | - |
| NYHA class ≥3# | |||||
| Yes | 22 (36.7) | 38 (63.3) | 1.71 | 0.90-3.24 | 0.096 |
| No | 41 (25.3) | 121 (74.7) | 1.00 | Reference | - |
| Anemia (Hb <100g/l) | |||||
| Yes | 12 (42.9) | 16 (57.1) | 2.10 | 0.92-4.78 | 0.070 |
| No | 51 (26.3) | 143 (73.7) | 1.00 | Reference | - |
| Renal insufficiency (eGFR <60) | |||||
| Yes | 18 (41.9) | 25 (58.1) | 2.14 | 1.06-4.33 | 0.029 |
| No | 45 (25.1) | 134 (74.9) | 1.00 | Reference | - |
| Chronic preoperative medications | |||||
| Beta-blockers | |||||
| Yes | 34 (29.8) | 80 (70.2) | 1.16 | 0.64-2.08 | 0.624 |
| No | 29 (26.9) | 79 (73.2) | 1.00 | Reference | - |
| Calcium antagonists | |||||
| Yes | 6 (21.4) | 22 (78.6) | 0.66 | 0.25-1.71 | 0.384 |
| No | 57 (29.4) | 137 (70.6) | 1.00 | Reference | - |
| ACEI or angiotensin-II blocker | |||||
| Yes | 23 (22.6) | 79 (77.5) | 0.58 | 0.32-1.07 | 0.076 |
| No | 40 (33.3) | 80 (66.7) | 1.00 | Reference | - |
| Diuretics | |||||
| Yes | 26 (34.2) | 50 (65.8) | 1.53 | 0.83-2.81 | 0.165 |
| No | 37 (25.3) | 109 (74.7) | 1.00 | Reference | - |
| Anti-platelets | |||||
| Yes | 38 (25.7) | 110 (74.3) | 0.68 | 0.37-1.25 | 0.201 |
| No | 25 (33.8) | 49 (66.2) | 1.00 | Reference | - |
| Surgical and intraoperative characteristics | PCVD | OR | 95% CI | P | |
| Yes, n (%) | No, n (%) | ||||
| Type of surgery | |||||
| CABG | 21 (25.9) | 60 (74.1) | 1.00 | Reference | - |
| AVR | 30 (28.0) | 77 (72.0) | 1.11 | 0.58-3.13 | 0.747 |
| Combined | 12 (35.3) | 22 (64.7) | 1.56 | 0.66-3.69 | 0.313 |
| Previous cardiac surgery | |||||
| Yes | 1 (36.0) | 14 (64.0) | 0.17 | 0.02-1.33 | 0.054 |
| No | 62 (27.4) | 145 (72.6) | 1.00 | Reference | - |
| Bleeding | |||||
| Yes | 16 (42.1) | 22 (57.9) | 2.12 | 1.02-4.41 | 0.040 |
| No | 47 (25.5) | 137 (74.5) | 1.00 | Reference | - |
| Long aortic clamping time* | |||||
| Yes | 24 (45.3) | 29 (54.7) | 2.76 | 1.42-5.36 | <0.001 |
| No | 39 (23.1) | 130 (76.9) | 1.00 | Reference | - |
| Long CBP time** | |||||
| Yes | 23 (43.4) | 30 (56.6) | 2.42 | 1.26-4.79 | 0.006 |
| No | 40 (23.7) | 129 (76.3) | 1.00 | Reference | - |
| Prebypass GIK | |||||
| Yes | 18 (16.4) | 92 (83.6) | 0.29 | 0.15-0.56 | <0.001 |
| No | 45 (40.2) | 67 (59.8) | 1.00 | Reference | - |
| Blood transfusion | |||||
| Yes | 41 (27.7) | 107 (72.3) | 0.91 | 0.49-1.68 | 0.753 |
| No | 22 (29.7) | 52 (70.3) | 1.00 | Reference | - |
| Fresh frozen plasma | |||||
| Yes | 22 (33.9) | 43 (66.2) | 1.45 | 0.77-2.71 | 0.246 |
| No | 41 (26.1) | 116 (73.9) | 1.00 | Reference | - |
| Platelets | |||||
| Yes | 13 (36.1) | 23 (63.9) | 1.54 | 0.72-3.28 | 0.262 |
| No | 50 (26.9) | 136 (73.1) | 1.00 | Reference | - |
| Fluids (>12.5 mL/min) | |||||
| Yes | 26 (23.4) | 85 (76.6) | 0.61 | 0.34-1.11 | 0.102 |
| No | 37 (33.3) | 74 (66.7) | 1.00 | Reference | - |
*>75 percentile stratified for surgery: CABG >80 min, AVR >96 min; combined >120 min, **>75 percentile stratified for surgery: CABG >120 min, AVR >127 min; combined >160 min. ACEI: Angiotensin-converting enzyme inhibitors, eGFR: Estimated glomerular filtration rate, Hb: Hemoglobin, NYHA: New York Heart Association functional classification of heart failure, CABG: Coronary artery bypass graft, AVR: Aortic valve replacement, CPB: Cardiopulmonary bypass, PCVD: Postcardiotomy ventricular dysfunction, OR: Odds ratio, CI: Confidence interval, GIK: Glucose-insulin-potassium, LVEF: Left ventricular ejection fraction