• MendesManuel AzevedoMADepartment of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium. Electronic address: m.mendes@chuliege.be., Marie Fabre, Philippe Amabili, Oceane Jaquet, Anne-Françoise Donneau, Vincent Bonhomme, and Gregory A Hans.
• Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium. Electronic address: m.mendes@chuliege.be.
• J. Cardiothorac. Vasc. Anesth. 2023 Oct 1; 37 (10): 196719731967-1973.

ObjectivesThe authors aimed to develop a simple prediction score to help identify patients at high risk of low-cardiac-output syndrome after adult cardiac surgery.DesignA single-center, retrospective, observational study.SettingAt a tertiary hospital.ParticipantsAdult patients who underwent on-pump cardiac surgery between April 2016 and March 2021.InterventionNone.Measurements And Main ResultsAmong the 2,806 patients retained for final analyses, 355 (12.7%) developed low-cardiac-output syndrome. Using a stepwise backward variable selection procedure applied to a multivariate logistic regression, a prediction model, including 8 risk factors, could be identified-preoperative left ventricular ejection fraction, glomerular filtration rate <60 mL/min according to the Cockcroft formula or preoperative dialysis, combined surgery, nonelective surgery, mitral valve surgery for mitral valve regurgitation, history of extracardiac arteriopathy, preoperative hemoglobin <13 g/dL, and New York Heart Association functional class III or IV. A clinical prediction score was derived from the regression coefficients. The model had a good discriminative ability, with an area under the receiver operating characteristics curve of 0.8 (95% CI: 077-0.84). Using a threshold value of 5, the score had a 68% sensitivity, 79% specificity, a positive-predictive value of 33%, and a negative-predictive value of 94%. These results were validated on a validation sample using the bootstrap resampling technique.ConclusionsThe authors developed a clinical score to facilitate the prediction of low- cardiac-output syndrome after adult cardiac surgery. This could help tailor patient management by contributing to the early identification of those at high risk of postoperative low cardiac output.Copyright © 2023 Elsevier Inc. All rights reserved.

17 keywords...

hide…