Effect of Diastolic Dysfunction on Postoperative Outcomes after Cardiovascular Surgery: a Systematic Review and Meta-Analysis
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Autor
Kaw, RoopHernandez, Adrian V.
Pasupuleti, Vinay
Deshpande, Abhishek
Nagarajan, Vijaiganesh
Bueno, Hector
Coleman, Craig I.
Ioannidis, John P.A.
Bhatt, Deepak L.
Blackstone, Eugene H.
Fecha de publicación
2016-06
Metadatos
Mostrar el registro completo del ítemCitation
Effect of Diastolic Dysfunction on Postoperative Outcomes after Cardiovascular Surgery: a Systematic Review and Meta-Analysis 2016 The Journal of Thoracic and Cardiovascular SurgeryEditorial
Elsevier B.V.Journal
The Journal of Thoracic and Cardiovascular SurgeryDOI
10.1016/j.jtcvs.2016.05.057Enlaces adicionales
http://linkinghub.elsevier.com/retrieve/pii/S0022522316304950Resumen
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-analysisTipo
info:eu-repo/semantics/articleDerechos
info:eu-repo/semantics/embargoedAccessIdioma
engDescripción
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.ISSN
00225223ae974a485f413a2113503eed53cd6c53
10.1016/j.jtcvs.2016.05.057
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