The effect of using microplegia on perioperative morbidity and mortality in elderly patients undergoing cardiac surgery

Turki B. Albacker, Rakesh Chaturvedi, Adil H. Al Kindi, Hamad Al-Habib, Talal Al-Atassi, Benoit De Varennes, Kevin Lachapelle

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Old age is a significant risk factor for perioperative morbidity and mortality following cardiac surgery and optimal myocardial protection strategy should be sought in this group of patients. We, therefore, reviewed the data on 295 consecutive patients older than 75 years who underwent any cardiac surgical procedure. Microplegia was used in 144 patients compared to 151 patients who had the standard 4:1 blood cardioplegia. Logistic regression analysis was used for propensity matching to balance the differences between the two groups. The microplegia group included more females and sicker patients as indicated by higher Parsonnet scores. There were differences in the pump time, aortic cross-clamp time, procedure type and surgeons between the two groups. These differences were balanced using the propensity matching. In-hospital mortality, acute renal injury and confusion were higher in the microplegia group (17%, 34%, 35%, respectively) compared to the standard 4:1 cardioplegia group (9%, 23%, 24%, respectively) (P=0.04, 0.04, 0.04, respectively). These differences were not statistically significant after propensity matching. These results demonstrate that the use of microplegia is safe in patients older than 75 years who are undergoing cardiac surgery and results in similar in-hospital morbidity and mortality to the standard 4:1 blood cardioplegia.

Original languageEnglish
Pages (from-to)56-60
Number of pages5
JournalInteractive Cardiovascular and Thoracic Surgery
Volume9
Issue number1
DOIs
Publication statusPublished - Jul 2009

Fingerprint

Thoracic Surgery
Morbidity
Induced Heart Arrest
Mortality
Hospital Mortality
Cardiac Surgical Procedures
Acute Kidney Injury
Logistic Models
Regression Analysis

Keywords

  • Cardioplegia
  • Microplegia
  • Morbidity
  • Mortality
  • Myocardial protection

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

The effect of using microplegia on perioperative morbidity and mortality in elderly patients undergoing cardiac surgery. / Albacker, Turki B.; Chaturvedi, Rakesh; Al Kindi, Adil H.; Al-Habib, Hamad; Al-Atassi, Talal; De Varennes, Benoit; Lachapelle, Kevin.

In: Interactive Cardiovascular and Thoracic Surgery, Vol. 9, No. 1, 07.2009, p. 56-60.

Research output: Contribution to journalArticle

Albacker, Turki B. ; Chaturvedi, Rakesh ; Al Kindi, Adil H. ; Al-Habib, Hamad ; Al-Atassi, Talal ; De Varennes, Benoit ; Lachapelle, Kevin. / The effect of using microplegia on perioperative morbidity and mortality in elderly patients undergoing cardiac surgery. In: Interactive Cardiovascular and Thoracic Surgery. 2009 ; Vol. 9, No. 1. pp. 56-60.
@article{1248a0a2880f4990981dec67ed8b7ca3,
title = "The effect of using microplegia on perioperative morbidity and mortality in elderly patients undergoing cardiac surgery",
abstract = "Old age is a significant risk factor for perioperative morbidity and mortality following cardiac surgery and optimal myocardial protection strategy should be sought in this group of patients. We, therefore, reviewed the data on 295 consecutive patients older than 75 years who underwent any cardiac surgical procedure. Microplegia was used in 144 patients compared to 151 patients who had the standard 4:1 blood cardioplegia. Logistic regression analysis was used for propensity matching to balance the differences between the two groups. The microplegia group included more females and sicker patients as indicated by higher Parsonnet scores. There were differences in the pump time, aortic cross-clamp time, procedure type and surgeons between the two groups. These differences were balanced using the propensity matching. In-hospital mortality, acute renal injury and confusion were higher in the microplegia group (17{\%}, 34{\%}, 35{\%}, respectively) compared to the standard 4:1 cardioplegia group (9{\%}, 23{\%}, 24{\%}, respectively) (P=0.04, 0.04, 0.04, respectively). These differences were not statistically significant after propensity matching. These results demonstrate that the use of microplegia is safe in patients older than 75 years who are undergoing cardiac surgery and results in similar in-hospital morbidity and mortality to the standard 4:1 blood cardioplegia.",
keywords = "Cardioplegia, Microplegia, Morbidity, Mortality, Myocardial protection",
author = "Albacker, {Turki B.} and Rakesh Chaturvedi and {Al Kindi}, {Adil H.} and Hamad Al-Habib and Talal Al-Atassi and {De Varennes}, Benoit and Kevin Lachapelle",
year = "2009",
month = "7",
doi = "10.1510/icvts.2009.204990",
language = "English",
volume = "9",
pages = "56--60",
journal = "Interactive Cardiovascular and Thoracic Surgery",
issn = "1569-9293",
publisher = "European Association for Cardio-Thoracic Surgery",
number = "1",

}

TY - JOUR

T1 - The effect of using microplegia on perioperative morbidity and mortality in elderly patients undergoing cardiac surgery

AU - Albacker, Turki B.

AU - Chaturvedi, Rakesh

AU - Al Kindi, Adil H.

AU - Al-Habib, Hamad

AU - Al-Atassi, Talal

AU - De Varennes, Benoit

AU - Lachapelle, Kevin

PY - 2009/7

Y1 - 2009/7

N2 - Old age is a significant risk factor for perioperative morbidity and mortality following cardiac surgery and optimal myocardial protection strategy should be sought in this group of patients. We, therefore, reviewed the data on 295 consecutive patients older than 75 years who underwent any cardiac surgical procedure. Microplegia was used in 144 patients compared to 151 patients who had the standard 4:1 blood cardioplegia. Logistic regression analysis was used for propensity matching to balance the differences between the two groups. The microplegia group included more females and sicker patients as indicated by higher Parsonnet scores. There were differences in the pump time, aortic cross-clamp time, procedure type and surgeons between the two groups. These differences were balanced using the propensity matching. In-hospital mortality, acute renal injury and confusion were higher in the microplegia group (17%, 34%, 35%, respectively) compared to the standard 4:1 cardioplegia group (9%, 23%, 24%, respectively) (P=0.04, 0.04, 0.04, respectively). These differences were not statistically significant after propensity matching. These results demonstrate that the use of microplegia is safe in patients older than 75 years who are undergoing cardiac surgery and results in similar in-hospital morbidity and mortality to the standard 4:1 blood cardioplegia.

AB - Old age is a significant risk factor for perioperative morbidity and mortality following cardiac surgery and optimal myocardial protection strategy should be sought in this group of patients. We, therefore, reviewed the data on 295 consecutive patients older than 75 years who underwent any cardiac surgical procedure. Microplegia was used in 144 patients compared to 151 patients who had the standard 4:1 blood cardioplegia. Logistic regression analysis was used for propensity matching to balance the differences between the two groups. The microplegia group included more females and sicker patients as indicated by higher Parsonnet scores. There were differences in the pump time, aortic cross-clamp time, procedure type and surgeons between the two groups. These differences were balanced using the propensity matching. In-hospital mortality, acute renal injury and confusion were higher in the microplegia group (17%, 34%, 35%, respectively) compared to the standard 4:1 cardioplegia group (9%, 23%, 24%, respectively) (P=0.04, 0.04, 0.04, respectively). These differences were not statistically significant after propensity matching. These results demonstrate that the use of microplegia is safe in patients older than 75 years who are undergoing cardiac surgery and results in similar in-hospital morbidity and mortality to the standard 4:1 blood cardioplegia.

KW - Cardioplegia

KW - Microplegia

KW - Morbidity

KW - Mortality

KW - Myocardial protection

UR - http://www.scopus.com/inward/record.url?scp=67650152230&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67650152230&partnerID=8YFLogxK

U2 - 10.1510/icvts.2009.204990

DO - 10.1510/icvts.2009.204990

M3 - Article

VL - 9

SP - 56

EP - 60

JO - Interactive Cardiovascular and Thoracic Surgery

JF - Interactive Cardiovascular and Thoracic Surgery

SN - 1569-9293

IS - 1

ER -