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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2013 August;54(4):545-52

Copyright © 2013 EDIZIONI MINERVA MEDICA

lingua: Inglese

Organized follow-up is essential for the evaluation of cardiac surgery

Noyez L.

Department of Cardio-Thoracic Surgery, Heart Center, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands


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Aim: Follow-up in adult cardiac surgery seems problematic. Mostly only hospital data are presented. Evaluation of performed cardiac surgery, is based on these data. However is this appropriate? This study evaluates the results of our follow-up (FU) in terms of completeness, drop out and survival in relation to the operative risk and the difference between hospital mortality, 30-day, 6-month and 1-year mortality.
Methods: Three thousand three hundred twenty-eight patients operated between January 2007 and December 2010 were included. Hospital mortality was 1.68% (56/3328). The date of mortality or the last date of information is endpoint. Our FU is twofold, the Organized FU (OFU) a yearly performed FU by mean of a written survey directly to all patients. A non-organized FU (NOFU) covering all information supplied spontaneously by cardiologists, general practitionars, family or others.
Results: Completeness decreases from 99.1% at 30-days over 85.6% at 1-year postoperative. During the first year there is no statistical significant difference between patients in or lost for FU, concerning age and Euroscore risk. Survival analysis shows a difference in one-year survival related to the risk.The statistical difference between hospital mortality and the registered 30-day, 6-month and 1-year mortality is related to the Euroscore risk class but also to the number of unobserved patients survival or mortality.
Conclusion: This study shows that hospital mortality, 30-day-, 6 months- and 1-year mortality is related to the operative risk and the number of unobserved patients Most efficient seems an OFU at one year postoperative, where not only mortality but also survival is registered.

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l.noyez@ctc.umcn.nl