Effect of Diastolic Dysfunction on Postoperative Outcomes after Cardiovascular Surgery: a Systematic Review and Meta-Analysis

2.50
Hdl Handle:
http://hdl.handle.net/10757/613065
Title:
Effect of Diastolic Dysfunction on Postoperative Outcomes after Cardiovascular Surgery: a Systematic Review and Meta-Analysis
Authors:
Kaw, Roop; Hernandez, Adrian V. ( 0000-0002-9999-4003 ) ; Pasupuleti, Vinay; Deshpande, Abhishek; Nagarajan, Vijaiganesh; Bueno, Hector; Coleman, Craig I.; Ioannidis, John P.A.; Bhatt, Deepak L.; Blackstone, Eugene H.
Citation:
Effect of Diastolic Dysfunction on Postoperative Outcomes after Cardiovascular Surgery: a Systematic Review and Meta-Analysis 2016 The Journal of Thoracic and Cardiovascular Surgery
Publisher:
Elsevier B.V.
Journal:
The Journal of Thoracic and Cardiovascular Surgery
Issue Date:
Jun-2016
URI:
http://hdl.handle.net/10757/613065
DOI:
10.1016/j.jtcvs.2016.05.057
Additional Links:
http://linkinghub.elsevier.com/retrieve/pii/S0022522316304950
Abstract:
Objective The objective of this study was to investigate the effect of preoperative diastolic dysfunction on postoperative mortality and morbidity after cardiovascular surgery. Methods We systematically searched for articles that assessed the prognostic role of diastolic dysfunction on cardiovascular surgery in PubMed, Cochrane Library, Web of Science, Embase and Scopus until February 2016. Twelve studies (n=8224) met our inclusion criteria. Due to scarcity of outcome events, fixed-effects meta-analysis was performed using the Mantel-Haenszel method. Results Preoperative diagnosis of diastolic dysfunction was associated with higher postoperative mortality (OR 2.41, 95% CI 1.54-3.71; p<0.0001), major adverse cardiac events (MACE) (OR 2.07, 95% CI 1.55-2.78; p <=0.0001) and prolonged mechanical ventilation (OR 2.08, 95% CI 1.04-4.16; p=0.04) in comparison to patients without diastolic dysfunction among patients who underwent cardiovascular surgery. The odds of postoperative myocardial infarction (OR: 1.29, 95% CI 0.82, 2.05; p=0.28) and atrial fibrillation (OR: 2.67; 95% CI 0.49-14.43; p=0.25) did not significantly differ between the two groups. Severity of preoperative diastolic dysfunction was associated with increased postoperative mortality (OR 21.22, 95% CI 3.74 -120.33; p=0.0006) for Grade 3 diastolic dysfunction compared with patients with normal diastolic function. Inclusion of left ventricular ejection fraction (LVEF) <40% accompanying diastolic dysfunction, did not further impact postoperative mortality (p=0.27; I2 =18%) when compared with patients with normal LVEF and diastolic dysfunction. Conclusions Presence of preoperative diastolic dysfunction was associated with higher postoperative mortality and MACE, regardless of LVEF. Mortality was significantly higher in grade III diastolic dysfunction. Keywords Diastolic dysfunction; cardiovascular surgical procedures; mortality; meta-analysis
Type:
info:eu-repo/semantics/article
Rights:
info:eu-repo/semantics/embargoedAccess
Language:
eng
Description:
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.
Keywords:
Diastolic dysfunction; Cardiovascular surgical procedures; Mortality; Meta-analysis
ISSN:
00225223

Full metadata record

DC FieldValue Language
dc.contributor.authorKaw, Roopes_PE
dc.contributor.authorHernandez, Adrian V.es_PE
dc.contributor.authorPasupuleti, Vinayes_PE
dc.contributor.authorDeshpande, Abhishekes_PE
dc.contributor.authorNagarajan, Vijaiganeshes_PE
dc.contributor.authorBueno, Hectores_PE
dc.contributor.authorColeman, Craig I.es_PE
dc.contributor.authorIoannidis, John P.A.es_PE
dc.contributor.authorBhatt, Deepak L.es_PE
dc.contributor.authorBlackstone, Eugene H.es_PE
dc.date.accessioned2016-06-14T16:17:15Zes_PE
dc.date.available2016-06-14T16:17:15Zes_PE
dc.date.issued2016-06es_PE
dc.identifier.citationEffect of Diastolic Dysfunction on Postoperative Outcomes after Cardiovascular Surgery: a Systematic Review and Meta-Analysis 2016 The Journal of Thoracic and Cardiovascular Surgeryes_PE
dc.identifier.issn00225223es_PE
dc.identifier.doi10.1016/j.jtcvs.2016.05.057es_PE
dc.identifier.urihttp://hdl.handle.net/10757/613065es_PE
dc.descriptionEl texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.es_PE
dc.description.abstractObjective The objective of this study was to investigate the effect of preoperative diastolic dysfunction on postoperative mortality and morbidity after cardiovascular surgery. Methods We systematically searched for articles that assessed the prognostic role of diastolic dysfunction on cardiovascular surgery in PubMed, Cochrane Library, Web of Science, Embase and Scopus until February 2016. Twelve studies (n=8224) met our inclusion criteria. Due to scarcity of outcome events, fixed-effects meta-analysis was performed using the Mantel-Haenszel method. Results Preoperative diagnosis of diastolic dysfunction was associated with higher postoperative mortality (OR 2.41, 95% CI 1.54-3.71; p<0.0001), major adverse cardiac events (MACE) (OR 2.07, 95% CI 1.55-2.78; p <=0.0001) and prolonged mechanical ventilation (OR 2.08, 95% CI 1.04-4.16; p=0.04) in comparison to patients without diastolic dysfunction among patients who underwent cardiovascular surgery. The odds of postoperative myocardial infarction (OR: 1.29, 95% CI 0.82, 2.05; p=0.28) and atrial fibrillation (OR: 2.67; 95% CI 0.49-14.43; p=0.25) did not significantly differ between the two groups. Severity of preoperative diastolic dysfunction was associated with increased postoperative mortality (OR 21.22, 95% CI 3.74 -120.33; p=0.0006) for Grade 3 diastolic dysfunction compared with patients with normal diastolic function. Inclusion of left ventricular ejection fraction (LVEF) <40% accompanying diastolic dysfunction, did not further impact postoperative mortality (p=0.27; I2 =18%) when compared with patients with normal LVEF and diastolic dysfunction. Conclusions Presence of preoperative diastolic dysfunction was associated with higher postoperative mortality and MACE, regardless of LVEF. Mortality was significantly higher in grade III diastolic dysfunction. Keywords Diastolic dysfunction; cardiovascular surgical procedures; mortality; meta-analysises_PE
dc.formatapplication/htmles_PE
dc.language.isoenges_PE
dc.publisherElsevier B.V.es_PE
dc.relation.urlhttp://linkinghub.elsevier.com/retrieve/pii/S0022522316304950es_PE
dc.rightsinfo:eu-repo/semantics/embargoedAccesses_PE
dc.sourceUniversidad Peruana de Ciencias Aplicadas (UPC)es_PE
dc.sourceRepositorio Académico - UPCes_PE
dc.subjectDiastolic dysfunctiones_PE
dc.subjectCardiovascular surgical procedureses_PE
dc.subjectMortalityes_PE
dc.subjectMeta-analysises_PE
dc.titleEffect of Diastolic Dysfunction on Postoperative Outcomes after Cardiovascular Surgery: a Systematic Review and Meta-Analysises_PE
dc.typeinfo:eu-repo/semantics/articlees_PE
dc.identifier.journalThe Journal of Thoracic and Cardiovascular Surgeryes_PE
dc.description.peer-reviewRevisión por pareses_PE
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