Comparison of some parameters in estimating in-hospital mortality risk in patients undergoing open-heart surgery

Despite accumulating evidence showing the importance of various scoring systems in predicting preoperative mortality rates among patients who are undergoing open cardiac surgery, the prediction of in-hospital mortality is still limited. This study aimed to investigate the contributing factors associated with in-hospital mortality in patients who undergo cardiac surgery.

All patients, aged 19 to 80 years, who underwent cardiac surgery between February 2019 and November 2020 at our tertiary healthcare institute were analyzed retrospectively. Demographic details, transthoracic echocardiography data, operation-related details, cardiopulmonary bypass time and laboratory measurement results were retrieved from the institutional digital database.

Data was available for a total of 311 subjects whose median age was 59 (52-67) years, and 65% of which were male. Among these 311 subjects, 296 (95%) were successfully discharged; however, in-hospital mortality was observed in 15 (5%) patients. Multiple logistic regression analysis revealed that low ejection fraction (p=0.049 and p=0.018), emergency surgery (p=0.022), low postoperative platelet (p=0.002) and high postoperative creatinine (p=0.007) were the most significant risk factors of mortality.

In conclusion, in a population of subjects undergoing cardiac and thoracic surgery, the in-hospital mortality rate was 4.8%. Left ventricular ejection fraction (LVEF) <40%, emergency surgery, postoperative platelet count and postoperative creatinine were significant risk factors for mortality.