Related Experiment Video
Updated: Aug 20, 2026
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Cardiac surgery in an Iranian teaching hospital: outcome and risk factors
Seyed-Ahmad Hassantash1, Koorosh Mirpoor, Maryam Afrakhteh
1Department of Cardiovascular Surgery, Shahid Beheshti University of Medical Sciences, Saadat-Abad, Tehran, Iran. sahassan@pol.net
Insights
This study identified key risk factors for mortality and morbidity in Iranian cardiac surgery patients. Age, emergency procedures, and patient condition significantly impacted outcomes, highlighting the need for tailored risk stratification models.
Area of Science:
- Cardiology
- Thoracic Surgery
- Public Health
Background:
- Cardiac surgery outcomes research often relies on data from Western countries, potentially not reflecting unique challenges in other regions like Iran.
- Iran's healthcare system presents distinct factors regarding facilities, equipment, and patient demographics that may influence surgical outcomes.
Purpose of the Study:
- To prospectively identify and analyze risk factors associated with mortality and morbidity in adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) in Iran.
- To establish a foundation for developing localized risk stratification models relevant to the Iranian patient population.
Main Methods:
- A prospective study enrolled 730 adult patients undergoing cardiac surgery with CPB over 15 months at a university-affiliated hospital.
- Statistical analyses were performed to determine correlations between various patient and procedural factors and the incidence of mortality and morbidity.
Main Results:
- The overall study group experienced a 5.3% mortality rate and a 14.8% morbidity rate.
- Factors significantly correlated with mortality included advanced age, emergency surgery, redo cardiac surgery, left ventricular aneurysm, catastrophic patient states, low ejection fraction, hypertension history, surgeon, and CPB duration.
- Factors associated with morbidity included female gender, age, emergency surgery, redo surgery, and catastrophic states.
Conclusions:
- Age, emergency surgery, redo cardiac surgery, and catastrophic patient states are statistically significant predictors for both mortality and morbidity in this Iranian cardiac surgery cohort.
- These findings underscore the importance of considering specific regional factors and patient characteristics when assessing cardiac surgery risks and developing clinical guidelines.
Abstract:
Cardiac surgery in Iran has been associated with different facilities, equipment and patient populations in comparison to countries from which most of the academic papers used for identification of risk factors related to outcome and subsequent establishment of risk stratification models originate from. During a 15-month period all patients admitted for adult cardiac surgery using cardiopulmonary bypass (CBP) in a university affiliated teaching hospital were enrolled in a prospective study. Appropriate statistical tests were used to analyze data for mortality and morbidity. There were 730 adults (63% male, 37% female), with age ranged from 16 to 82 (mean, 51.4 +/- 14.4). A mortality rate of 5.3% and morbidity of 14.8% (major + minor) were observed in the whole group. Factors correlated with mortality were: age (p = 0.019), emergency surgery (p < 0.0001), redo cardiac surgery (p = 0.01), left ventricular (LV) aneurysm (p < 0.001), presence of catastrophic states (p < 0.001), low ejection fraction (p = 0.04), history of hypertension (p = 0.05), the individual surgeon (p < 0.0001), and CPB duration (p < 0.0001). Factors affecting morbidity included: female gender (p = 0.04), age (p = 0.03), emergency surgery (p = 0.001), redo surgery (p = 0.008), and catastrophic states (p < 0.001). The mortality in our study group may be compared with reports presented in the literature. Factors such as age, emergency surgery, redo cardiac surgery, and catastrophic states are statistically related to both mortality and morbidity.
