Premium
Preoperative percutaneous oxygen saturation is a predictor of postoperative adverse events after Ebstein's anomaly reconstruction
Author(s) -
Yang Yao,
Zhang Wei,
Liu Yang,
Li Gang,
Zhang Han,
Fan Xing,
Su Junwu,
Liu Yinglong,
Fan Xiangming
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15373
Subject(s) - medicine , receiver operating characteristic , extracorporeal membrane oxygenation , cardiopulmonary bypass , odds ratio , univariate analysis , adverse effect , mechanical ventilation , anesthesia , cardiology , retrospective cohort study , percutaneous , surgery , multivariate analysis
Background Ebstein's anomaly (EA) is a kind of congenital heart disease, which is currently widely treated by cone reconstruction. However, the prediction of postoperative recovery is still challenging. Methods A retrospective analysis was performed on EA cases undergoing cone reconstruction from January 2010 to January 2016. Univariate and multivariate logistic regression analyses were performed, with postoperative adverse events defined as dependent variable and pre‐ and intraoperative parameters defined as independent variables. The predictive capacity of preoperative percutaneous oxygen saturation (SPO 2 ) and Great Ormond Street (GOS) score was evaluated using areas under the curve of the receiver operating characteristic (ROC). Results Preoperative SPO 2 was 95.7 ± 5.20%. Cardiopulmonary bypass, aortic cross‐clamp, postoperative mechanical ventilation, and hospitalization time were 101.7 ± 28.26 min, 60.9 ± 18.04 min, 16 h (8, 22), and 8 days (7, 11), respectively. The incidence of total postoperative adverse events, including low cardiac output syndrome, mechanical ventilation more than 3 days, postoperative hospitalization more than 2 weeks, postoperative reintubation, extracorporeal membrane oxygenation assistance, and death, was 13.1% ( n = 13). Low preoperative SPO 2 ( p = .001, odds ratio [OR] = 0.834), GOS score ( p = .021, OR = 0.368), and cardiopulmonary bypass time ( p = .034, OR = 1.021) were risk factors for adverse events. Multivariate logistic regression analysis showed that low preoperative SPO 2 ( p = .002, OR = 0.846) and GOS score ( p = .043, OR = 0.577) were independent risk factors for adverse events. The areas of SPO 2 and GOS score under the ROC curve were 0.764 and 0.740, respectively. Conclusions Low preoperative SPO 2 and GOS score were predictors of adverse events after cone reconstruction, and SPO 2 was more convenient and objective than the GOS score.