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Incidence, Outcomes, and Risk Factors for Preincision Cardiac Arrest in Cardiac Surgery Patients
Mariya A Geube1, Albert Hsu1, Nikolaos J Skubas1
1From the Departments of Cardiothoracic Anesthesiology.
Anesthesia and Analgesia
|September 26, 2022
Summary
Preincision cardiac arrest is rare in cardiac surgery patients but significantly increases in-hospital mortality and postoperative complications. Reduced left ventricular ejection fraction and pulmonary hypertension are key risk factors.
Area of Science:
- Cardiology
- Cardiac Surgery
- Anesthesiology
Background:
- Preincision cardiac arrest is a critical event in cardiac surgery.
- Understanding its incidence and associated factors is crucial for patient safety.
Purpose of the Study:
- To determine the incidence of preincision cardiac arrest.
- To analyze postoperative outcomes in patients experiencing preincision cardiac arrest.
- To identify patient-related risk factors for preincision cardiac arrest.
Main Methods:
- Retrospective analysis of adult patients undergoing cardiac surgery (2008-2019).
- Defined preincision cardiac arrest as arrest between anesthesia induction and surgical incision.
- Used regression models to assess associations with postoperative outcomes and risk factors.
Main Results:
- Incidence of preincision cardiac arrest was 0.18% (75/41,238 patients).
- Patients with preincision arrest had higher in-hospital mortality (11% vs. 2%) and increased rates of respiratory failure, renal replacement therapy, and neurologic deficit.
- Reduced left ventricular ejection fraction and moderate/severe pulmonary hypertension were independent risk factors.
Conclusions:
- Preincision cardiac arrest, though rare, is associated with significantly worse patient outcomes.
- Early identification of patients with reduced left ventricular ejection fraction and pulmonary hypertension is vital for risk mitigation.
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