The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · May 2013
Depression before and after cardiac surgery: do all patients respond the same?
To characterize the prevalence, incidence, and risk factors for depression before and after cardiac surgery. ⋯ Depression is prevalent in one-third of cardiac surgery patients at time of discharge. It is not associated with operative or postoperative risk factors, with the exception of prolonged hospital stay >7 days. Preoperative depression or being at risk for depression, is associated with the highest risk for postoperative depression.
-
J. Thorac. Cardiovasc. Surg. · May 2013
Development of a diagnosis- and procedure-based risk model for 30-day outcome after pediatric cardiac surgery.
The study objective was to develop a risk model incorporating diagnostic information to adjust for case-mix severity during routine monitoring of outcomes for pediatric cardiac surgery. ⋯ The risk model performs well. Diagnostic information added useful discriminatory power. A future application is risk adjustment during routine monitoring of outcomes in the United Kingdom to assist quality assurance.
-
J. Thorac. Cardiovasc. Surg. · May 2013
Understanding right ventricular dysfunction and functional tricuspid regurgitation accompanying mitral valve disease.
The study objective was to correlate the degree of tricuspid regurgitation with clinical indicators of right-sided heart failure and both qualitative and quantitative measures of right-sided heart morphology and function in patients with degenerative mitral valve disease. ⋯ Functional tricuspid regurgitation accompanying mitral valve disease is associated with proportional changes in right-sided heart morphology; however, severe tricuspid regurgitation is nearly always associated with right ventricular dysfunction, suggesting a synergistic relationship. Right ventricular dysfunction is likely as important as tricuspid regurgitation because it offers an explanation for the negative prognostic impact of tricuspid regurgitation and has implications for the clinical management of patients.
-
J. Thorac. Cardiovasc. Surg. · May 2013
Comparative StudyNational perioperative outcomes of pulmonary lobectomy for cancer in the obese patient: a propensity score matched analysis.
Obesity in the United States is a growing epidemic that results in challenging patients with complicated comorbidities. We sought to compare hospital outcomes of obese patients with those of nonobese patients undergoing pulmonary lobectomy for cancer. ⋯ Obese patients have an increased risk for postoperative pulmonary complications but not other morbidity, mortality, or prolonged hospital length of stay after lobectomy for cancer. Obesity should not be considered a surgical risk factor for pulmonary resection.