Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

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


Issue's catalogue ➤ КФК. 2022; 19 (3): 193-286 ➤ Влияние коморбидности на непосредственные результаты хирургической коррекции клапанных пороков сердца

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

Keywords:  elderly patients comorbidity complications in the early postoperative period

Received / Accepted:  18.08.2022 / 07.09.2022

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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.

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****
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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

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