Risk Model of Cardiovascular Surgery in 845 Marfan Patients Using the Japan Adult Cardiovascular Surgery Database
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概要
- 論文の詳細を見る
The aim of this study was to evaluate the short-term operative results of patients with Marfan syndrome who underwent thoracic or abdominal aortic surgery in a 4-year period in Japan. Data were collected from the Japan Cardiovascular Surgery Database (JCVSD). We retrospectively analyzed the data of 845 patients with Marfan syndrome who underwent cardiovascular surgery between January 2008 and January 2011. Logistic regression was used to generate risk models. The early mortality rate was 4.4% (37/845). Odds ratios (OR), 95% confi dence intervals (CI), and <I>P</I> values for structures and processes in the mortality prediction model were as follows: renal insufficiency (OR, 11.37; CI, 3.7234.66; <I>P</I> < 0.001); respiratory disorder (OR, 11.12; CI, 3.20-38.67; <I>P</I> < 0.001); aortic dissection (OR, 13.02; CI, 2.8060.60; <I>P</I> = 0.001); pseudoaneurysm (OR, 11.23; CI, 1.38-91.66; <I>P</I> = 0.024); thoracoabdominal aneurysm (OR, 2.67; CI, 1.22-5.84; <I>P</I> = 0.014); and aortic rupure (OR, 4.23; CI, 1.26-14.23; <I>P</I> = 0.002). The mortality prediction model had a Cindex of 0.82 and a Hosmer–Lemeshow <I>P</I> value of 0.56. In conclusion, this study demonstrated that renal insuffi ciency and respiratory disorder had great impact on the operative mortality of Marfan patients undergoing cardiovascular surgery. Because patients with aortic dissection or aortic rupture showed high operative mortality, close follow-up to avoid emergency operation is mandatory to improve the operative results. Achieving good results from surgery of the thoracoabdominal aorta was quite challenging, also in Marfan patients.
- International Heart Journal刊行会の論文
著者
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Sawaki Daigo
Department of Cardiology, Tokyo University
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SUZUKI TOHRU
Department of Chemical Engineering, Faculty of Engineering, Nagoya University
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Hirata Yasunobu
Department Of Advanced Clinical Science And Therapeutics Cardiovascular Medicine Graduate School Of
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MIYAIRI Takeshi
Department of Cardiothoracic Surgery, University of Tokyo
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Taketani Tsuyoshi
Department Of Cardiothoracic Surgery The University Of Tokyo
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Takamoto Shinichi
Department Of Cardiac Surgery
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Shimizu Hideyuki
Deparment Of Surgery School Of Medicine Keio University
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Motomura Noboru
Department Of Cardiac Surgery Faculty Of Medicine Graduate School Of Medicine University Of Tokyo
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MIYATA Hiroaki
Department of Cardiac Surgery, Nagoya University Graduate School of Medicine
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Hirata Yasunobu
Department of Cardiology, Graduate School of Medicine, University of Tokyo
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Suzuki Tohru
Department of Ubiquitous Preventive Medicine, Graduate School of Medicine, University of Tokyo
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Sawaki Daigo
Department of Cardiology, Graduate School of Medicine, University of Tokyo
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MIYAIRI Takeshi
Department of Cardiothoracic Surgery, Faculty of Medicine, Tokyo University
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Motomura Noboru
Department of Cardiovascular Surgery, Graduate School of Medicine, University of Tokyo
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