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ABSTRACT: Objectives
To investigate the role of pulmonary artery pressure (PAP) in predicting in-hospital death after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease.Design
An observational study.Setting
Guangdong General Hospital, China.Participants
1639middle-aged and aged patients (mean age 57±6 years) diagnosed with rheumatic mitral disease, undergoing valve replacement surgery and receiving coronary angiography and transthoracic echocardiography before operation, were enrolled.Interventions
All participants underwent valve replacement surgery and received coronary angiography before operation.Primary and secondary outcome measures
In-hospital death and 1-year mortality after operation.Methods
Included patients were divided into four groups based on the preoperative PAP obtained by echocardiography: group A (PAP?30?mm Hg); group B (>30 mm HgResults
In-hospital mortality rate increased gradually but significantly as the PAP level increased, with 1.9% in group A (n=268), 2.3% in group B (n=771), 4.7% in group C (n=384) and 10.2% in group D (n=216) (p<0.001). Multivariate analysis showed that PAP>70?mm Hg was an independent predictor of in-hospital death (OR=2.93, 95%?CI 1.61 to 5.32, p<0.001). PAP>52.5?mm Hg had a sensitivity of 60.3% and specificity of 67.7% in predicting in-hospital death (area under the curve=0.672, 95%?CI 0.602 to 0.743, p<0.001). Kaplan-Meier analysis showed that patients with PAP>52.5?mm Hg had higher 1-year mortality after operation than those without (log-rank=21.51, p<0.001).Conclusions
PAP could serve as a predictor of postoperative in-hospital and 1-year mortality after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease.
SUBMITTER: Jiang L
PROVIDER: S-EPMC5777461 | biostudies-literature | 2017 May
REPOSITORIES: biostudies-literature
BMJ open 20170510 5
<h4>Objectives</h4>To investigate the role of pulmonary artery pressure (PAP) in predicting in-hospital death after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease.<h4>Design</h4>An observational study.<h4>Setting</h4>Guangdong General Hospital, China.<h4>Participants</h4>1639middle-aged and aged patients (mean age 57±6 years) diagnosed with rheumatic mitral disease, undergoing valve replacement surgery and receiving coronary angiography and transthoracic ...[more]