Value of autopsy in cardiac surgery

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00209775%3A_____%2F15%3A%230000327" target="_blank" >RIV/00209775:_____/15:#0000327 - isvavai.cz</a>

Výsledek na webu

<a href="http://dx.doi.org/10.1016/j.crvasa.2015.03.001" target="_blank" >http://dx.doi.org/10.1016/j.crvasa.2015.03.001</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.crvasa.2015.03.001" target="_blank" >10.1016/j.crvasa.2015.03.001</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Value of autopsy in cardiac surgery

Popis výsledku v původním jazyce

With improvements in preoperative diagnostics and postoperative care the value of autopsy has been questioned. The aim of our study was to prospectively assess the current value of autopsy in patients after cardiac surgery. Between January 2007 and December 2013 there were 7800 patients operated on for heart disease. Two hundred and thirteen of them died postoperatively, resulting in an overall in-hospital mortality of 2.7%. Autopsy was performed on 158 patients (74%). Data regarding the cause of death from clinical and autopsy findings were analysed and compared. Artificial ventilation, inotropic support before operation, NYHA class IV, and renal failure were the most common preoperative risk factors and surgery for postinfarction ventricular septal defect, emergency operation, operation for acute dissection, triple valve surgery and the necessity for ciirculatory arrest were the most significant operative risk factors. The most frequent cause of death was cardiac failure or a sepsis and/or multiorgan failure. Missed major diagnosis (class I and II) was found in 21 patients (13.3%) and missed minor diagnosis was found in 17 patients (10.4%). Of the seven patients with class I error, six died due to unidentified abdominal complications. Autopsy remains the most specific indicator of errors in diagnostics and surgery in patients with cardiac disease. It is a valuable tool for quality assessment and may contribute to the improvement of patient healthcare. Clinicians should pay special attention to abdominal symptomatology in patients after cardiac surgery because this was the main cause of diagnostic errors.

Název v anglickém jazyce

Value of autopsy in cardiac surgery

Popis výsledku anglicky

With improvements in preoperative diagnostics and postoperative care the value of autopsy has been questioned. The aim of our study was to prospectively assess the current value of autopsy in patients after cardiac surgery. Between January 2007 and December 2013 there were 7800 patients operated on for heart disease. Two hundred and thirteen of them died postoperatively, resulting in an overall in-hospital mortality of 2.7%. Autopsy was performed on 158 patients (74%). Data regarding the cause of death from clinical and autopsy findings were analysed and compared. Artificial ventilation, inotropic support before operation, NYHA class IV, and renal failure were the most common preoperative risk factors and surgery for postinfarction ventricular septal defect, emergency operation, operation for acute dissection, triple valve surgery and the necessity for ciirculatory arrest were the most significant operative risk factors. The most frequent cause of death was cardiac failure or a sepsis and/or multiorgan failure. Missed major diagnosis (class I and II) was found in 21 patients (13.3%) and missed minor diagnosis was found in 17 patients (10.4%). Of the seven patients with class I error, six died due to unidentified abdominal complications. Autopsy remains the most specific indicator of errors in diagnostics and surgery in patients with cardiac disease. It is a valuable tool for quality assessment and may contribute to the improvement of patient healthcare. Clinicians should pay special attention to abdominal symptomatology in patients after cardiac surgery because this was the main cause of diagnostic errors.

Druh

J_x - Nezařazeno - Článek v odborném periodiku (Jimp, Jsc a Jost)

CEP obor

FA - Kardiovaskulární nemoci včetně kardiochirurgie

OECD FORD obor

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Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2015

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Cor et Vasa

ISSN

0010-8650

e-ISSN

—

Svazek periodika

57

Číslo periodika v rámci svazku

2

Stát vydavatele periodika

CZ - Česká republika

Počet stran výsledku

4

Strana od-do

"e91"-"e94"

Kód UT WoS článku

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EID výsledku v databázi Scopus

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