Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Impact of comorbidity on immediate results of surgical correction of valvular heart defects

Authors: Nikitina T.G., Pelekh D.M., Filipkina T.Yu., Golukhova E.Z.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2022-19-3-238-246

UDC: 616.126.3-089.168

Link: Clinical Physiology of Blood Circulaiton. 2022; 3 (19): 238-246

Quote as: Nikitina T.G., Pelekh D.M., Filipkina T.Yu., Golukhova E.Z. Impact of comorbidity on immediate results of surgical correction of valvular heart defects. Clinical Physiology of Circulation. 2022; 19 (3): 238–46 (in Russ.). DOI: 10.24022/1814-6910-2022-19-3-238-246

Received / Accepted:  18.08.2022 / 07.09.2022

Download
Full text:  

Abstract

Objective. To evaluate the effect of comorbidity on the immediate results of surgical correction of valvular heart defects (VHD) ± coronary heart disease (CHD) in elderly patients.

Material and methods. 240 patients ≥ 60 years old (mean age 69.2 ±1.3 years) underwent correction of VHD ± CHD. 178 (74.2%) elderly before operations were classified as New York Heart Association (NYHA) functional class (FC) III, and 62 (25.8%) were classified as FC IV. The average EuroSCORE (ES) II in the elderly is 15.7 ± 3.3%. Before surgery, patients were assessed for comorbidity according to Charlson Comorbidity Index (CCI) – the average score was 8.5±1.1.

Results. Non-lethal complications in the early postoperative period were noted in 103 (42.9%) patients. An independent predictor of the development of postoperative complications was the CCI score ≥ 3 (p < 0.05). In the course of correlation analysis, we noted a statistically significant correlation between the scores obtained by CCI and the incidence of postoperative complications (p = 0.001). Hospital mortality in patients ≥ 60 years of age is 7.9% (n =19). In-hospital mortality in the early p/o period was influenced by CCI ≥ 3 (p < 0.05). At discharge from the clinic, 143 (64.7%) elderly patients switched to NYHA FC II, 78 (35.3%) – to NYHA FC III.

Conclusion. Elderly patients were highly comorbid before correction of VHD ± CHD. The CCI score ≥ 3 was a strong predictor of both early postoperative complications and in-hospital mortality. The majority (64.7%) of patients at discharge were in NYHA FC II, 35.3% – in FC III.

About Authors

  • Tat’yana G. Nikitina, Dr. Med. Sci., Professor, Leading Researcher; ORCID
  • Dmitriy M. Pelekh, Cand. Med. Sci., Researcher, Cardiologist; ORCID
  • Tat’yana Yu. Filipkina, Cand. Phys. and Math. Sci., Analyst
  • Elena Z. Golukhova, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Director; ORCID

 If you found mistakes, select text and press Alt+A