Skip to main content
SpringerLink
Log in

Peri- und frühpostoperative Morbidität und Mortalität bei herzchirurgischen Eingriffen

Peri- and early postoperative morbidity and mortality in cardiac surgery

  • Originalarbeiten
  • Published:
Acta Chirurgica Austriaca Aims and scope Submit manuscript

Zusammenfassung

Grundlagen: Durch die kontinuierliche Verbesserung der therapeutischen Verfahren in der Medizin und die deutliche Zunahme der interventionellen Kardiologie änderte sich das einer Herzoperation zugeführte Patientengut beträchtlich. Es stieg nicht nur das durchschnittliche Alter der Patienten, sondern auch die Komplexizität der Eingriffe, die Zahl der Notoperationen, Kombinations- und Rezidiveingriffe.

Methodik: In einer retrospektiven Studie über 1592 Patienten, welche sich in einem Zeitraum von 26 Monaten einem herzchirurgischen Eingriff unterzogen, analysierten wir die peri- und frühpostoperative Morbidität und Mortalität.

Ergebnisse: Die ausgewerteten Komplikationen unterteilten wir in kardiale (7,8%), nichtkardiale (5,6%) und chirurgische (2,9%) und berichten jeweils über deren Häufigkeit und Ursachen.

Schlußfolgerungen: Sowohl Fortschritte im medizinischen Bereich als auch die ständige Änderung des Patientengutes machen eine exakte Aufarbeitung der eigenen Ergebnisse zur Qualitätssicherung notwendig. Unsere Ergebnisse sollen einen repräsentativen Querschnitt einer „modernen Herzchirurgie” zeigen.

Summary

Background: Because of continuous improvement in diagnostic and therapeutical procedures in medicine and increase of interventional cardiology, the spectrum of patients undergoing open heart surgery, has changed remarkably. Not only the patients average age increased, but also the complexity of operations, the number of emergency operations, combination- and reoperations.

Methods: In a retrospective study on 1,592 patients undergoing cardiac surgery within 26 months, we analyzed peri- and early postoperative morbidity and mortality.

Results: We devided the analyzed complications into cardiac (7.8%), non-cardiac (5.6%) and surgery related (2.9%) and report on their number and origins.

Conclusions: Not only progress in medicine, but also the continuously changing spectrum of patients force us to review our results to keep a high standard in our field of surgery. Our results should give a representative spectrum of complications in “modern cardiac surgery”.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Birnbaum D, Betz P: Die extrakorporale Zirkulation als Risikofaktor der Herzchirurgie. Z Kardiol 1990; 79 (Suppl 4):87–93.

    PubMed  Google Scholar 

  2. Cambell C, Tolitano D, Weber K, Statler P, Replogle R: Mechanical support for postcardiotomy heart failure. J Card Surg 1988;3:181–191.

    Google Scholar 

  3. Corwin H, Sprague S, DeLaria G, Norusis M: Acute renal failure associated with cardiac operations. A case-control study. J Thorac Cardiovasc Surg 1989;98:1107–1112.

    PubMed  CAS  Google Scholar 

  4. Cosgrove D: Evaluation of perioperative risk factors. J Card Surg 1990;5 (Suppl 3): 227–230.

    PubMed  CAS  Google Scholar 

  5. Freeman W, Schaff H, O’Brien P, Orszulak T, Naessens J, Tajik A: Cardiac surgery in the octogenarian; perioperative outcome and clinical follow-up. J Am Coll Cardiol 1991;18:29–35.

    Article  PubMed  CAS  Google Scholar 

  6. Hannan E, Kilburn H, O’Donnel J, Lukacik G, Shields E: Adult open heart surgery in New York state: An analysis of risk factors and hospital mortality rates. JAMA 1990;264:2768–2774.

    Article  PubMed  CAS  Google Scholar 

  7. Hilll J D: John H. Gibbon, Jr. Part I. The developement of the first successful heart-lung machine. Ann Thorac surg 1982; 34(3): 337–341.

    Article  Google Scholar 

  8. Kalmar P: Quality assurance in cardiac surgery — history, preliminaries, practical experience. Thorac Cardiovasc Surg 1990;38:108–114.

    PubMed  CAS  Google Scholar 

  9. Leurs P, Mulder A, Fiers H, Hoorntje S: Acute renal failure after cardiovascular surgery: Current concepts in pathophysiology, prevention and treatment. Eur Heart J 1989;10 (Suppl H): 38–42.

    PubMed  Google Scholar 

  10. Lytle B, Loop F, Cosgrove D, Taylor P, Goormastic M, Peper W: Fifteenhundred coronary reoperations: results and determinants of early and late survival. J Thorac Cardiovasc Surg 1987;93:847–859.

    PubMed  CAS  Google Scholar 

  11. Martinez-Colon M, Vilaro-Nelms J: Cardiac surgery at the San Pablo Heart Institute: an update of statistics on surgical mortality and morbidity. Bol Ass Med P R 1991;83:440–447.

    CAS  Google Scholar 

  12. Mikheev A, Klembovskii A, Travin N, Silaev A: Operations on the coronary arteries of the working heart without using an apparatus for extracorporeal circulation. Grud Serd Khir 1991;10:23–26.

    Google Scholar 

  13. Naunheim K, Dean P, Fiore A, McBride L, Pennington D, Kaiser G, Willman V, Barner H: Cardiac surgery in the octogenarian. Eur J Cardiothorac Surg 1990;4:130–135.

    Article  PubMed  CAS  Google Scholar 

  14. Peuhkurinen K, Korhonen U: Diagnosis and management of early postoperative complications in open heart surgery. Ann Clin Res 1987;19:365–373.

    PubMed  CAS  Google Scholar 

  15. Rosenmurgy A, McAllister E, Karl R: The acute surgical abdomen after cardiac surgery involving extracorporeal circulation. Ann Surg 1988;207:323.

    Article  Google Scholar 

  16. Sellick J jr, Stelmach M, Mylotte J: Surveillance of surgical wound infections following open heart surgery. Infect Control Hosp Epidemiol 1991;12:591–596.

    Article  PubMed  Google Scholar 

  17. Shuhaiber H, Chugh T, Portoian-Shuhaiber S, Ghosh D: Wound infection in cardiac surgery. J Cardiovasc Surg Torino 1987;28:139–142.

    PubMed  CAS  Google Scholar 

  18. Struck E, De Vivie E, Hehrlein F, Hugel W, Kalmar P, Sebening F, Wilde E: Multicentric quality assurance in cardiac surgery. Thorac Cardiovasc Surg 1990;38:123–134.

    PubMed  CAS  Google Scholar 

  19. Triumbari F, Giammaria M, Alfieri O, Luisi S, Donadio P, Zannutini D, Fontana V, Pintor P: A quality control method in cardiac surgical outcome: experience in 462 patients. Qual Assur Health-Care 1991;3:235–239.

    PubMed  CAS  Google Scholar 

  20. Tuman K, McCarthy J, March R, Najafi H, Ivankovich A: Morbidity and Duration of ICU Stay after Cardiac Surgery. Chest 1992;102:36–44.

    PubMed  CAS  Google Scholar 

  21. Ulicny K Jr, Hiratzka L, Williams R, Grunkemeier G, Flege J jr, Wright C, Callard G, Mitts D, Dunn E: Sternotomy infection: poor prediction by acute phase response and delayed hypersensitivity. Ann Thorac Surg 1990;50:949–958.

    Article  PubMed  Google Scholar 

  22. Wechsler A, Abd-Elfattah A: Myocardial protection: what the surgeon does. J Card Surg 1990;5 (Suppl 3): 251–255.

    PubMed  CAS  Google Scholar 

  23. Wellens F, Vanermen H: Treatment of the infected cardiac suture line. J Card Surg 1988;3:109–118.

    PubMed  CAS  Google Scholar 

  24. Wilde E, Christof K, Struck E: Entwicklung und Anwendung eines qualitätssichernden Informationssystems in der Herzchirurgie (QUADRA-Studie). Thorac Cardiovasc Surg 1990;38:115–123.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. I. Chirurgische Abteilung, Allgemeines Krankenhaus, Krankenhausstraße 9, A-4020, Linz

    U. Klima, G. Wimmer-Greinecker, W. Harringer, R. Mair, C. Groß & P. Brücke

Authors
  1. U. Klima
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Wimmer-Greinecker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. Harringer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Mair
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C. Groß
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. Brücke
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Klima, U., Wimmer-Greinecker, G., Harringer, W. et al. Peri- und frühpostoperative Morbidität und Mortalität bei herzchirurgischen Eingriffen. Acta Chir Austriaca 26, 43–46 (1994). https://doi.org/10.1007/BF02619726

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02619726

Schlüsselwörter

Key-words

Search

Navigation