Medium-term outcomes of 78,808 patients after heart valve surgery in a middle-income country: a nationwide population-based study
Medium-term outcomes of 78,808 patients after heart valve surgery in a middle-income country: a nationwide population-based study
Data
2017
Autores
Xavier, Regina Maria de Aquino
Azevedo, Vitor Manuel Pereira
Godoy, Paulo Henrique
Migowski, Arn
Ribeiro, Antonio Luiz Pinho
Chaves, Rogério Brant Martins
Correia, Marcelo Goulart
Xavier, Carolina de Aquino
Hashimoto, Lucas de Aquino
Weksler, Clara
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Cardiovascular Disorders
Resumo
Background: Heart valve surgery outcomes are unknown in middle-income countries and thus cannot be used in
health system decision making processes. This study estimated in-hospital mortality and medium and long-term survival.
Methods: This was a retrospective study of 78,806 patients who underwent heart valve surgery between 2001 and 2007
in Brazil. Two national databases were used, the Hospital Information System and the Mortality Information System.
Kaplan-Meier survival analysis and log-rank tests were performed. Maximum and median follow-up was 7.7 and 2.8 years,
respectively (0.002–7.707).
Results: Valve replacement accounted for 69.1% of procedures performed. Mitral stenosis, the most common valve injury,
represented 38.9% of the total. In 94.7% of mitral stenosis patients, aetiology was rheumatic heart disease. In-hospital
mortality was 7.6% and was higher for women, for patients who had undergone concomitant coronary artery bypass
grafting (CABG) and for the elderly. Overall survival was 69.9% at the end of follow-up. Survival was worst among elderly,
male and concomitant CABG patients (P<0.001).
Conclusions: Rheumatic heart disease is still a major public health problem in Brazil. In-hospital mortality and global
survival rates of patients who have undergone heart valve surgery were less satisfactory than those reported in high-
income countries. The findings of this study can contribute to guiding decision making processes in middle-income
countries similar to Brazil and others concerned with improving the quality of care.
Description
Palavras-chave
Cardiac surgical procedures, Heart valve diseases, Survival analysis, Hospital mortality, Rheumatic heart disease, Medical record linkage, Brazil, Annular repair, cardiac valve
Citação
Aquino Xavier RM, Azevedo VMP, Godoy PH, Migowski A, Ribeiro ALP, Chaves RBM, Correia MG, de Aquino Xavier C, de Aquino Hashimoto L, Weksler C, Silva NASE. Medium-term outcomes of 78,808 patients after heart valve surgery in a middle-income country: a nationwide population-based study. BMC Cardiovasc Disord. 2017 Dec 28;17(1):302. doi: 10.1186/s12872-017-0725-9.