Influence of timing of intraaortic balloon placement in cardiac surgical patients

Lavana, Jayshree D., Fraser, John F., Smith, Susan E., Drake, Lesley, Tesar, Peter and Mullany, Daniel (2010) Influence of timing of intraaortic balloon placement in cardiac surgical patients. Journal of Thoracic and Cardiovascular Surgery, 140 1: 80-85. doi:10.1016/j.jtcvs.2009.09.033

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Author Lavana, Jayshree D.
Fraser, John F.
Smith, Susan E.
Drake, Lesley
Tesar, Peter
Mullany, Daniel
Title Influence of timing of intraaortic balloon placement in cardiac surgical patients
Journal name Journal of Thoracic and Cardiovascular Surgery   Check publisher's open access policy
ISSN 0022-5223
Publication date 2010-07
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.jtcvs.2009.09.033
Volume 140
Issue 1
Start page 80
End page 85
Total pages 6
Editor Lawrence H. Cohn
John S. Ikonomidis
Place of publication Beverly, MA, U.S.A.
Publisher Mosby
Collection year 2011
Language eng
Formatted abstract
Objective: The study objective was to evaluate the association between timing of intraaortic balloon pump insertion and outcomes in patients undergoing cardiac surgery.

Methods: All patients aged 18 years or more who underwent coronary artery bypass surgery, cardiac valve surgery, or thoracic aortic surgery between January 2002 and December 2007 were included. Data were obtained from cardiac surgery and intensive care databases. Patients were categorized as receiving a preoperative, intraoperative, or postoperative intraaortic balloon pump and compared with a reference group who did not receive an intraaortic balloon pump. Summary and descriptive statistics were used to compare the groups. Logistic regression was used to model in-hospital mortality, and survival methods were used to model time to event data, such as length of stay.

Results: There were 7440 patients included over a 6-year period, of whom 217 (2.9%) received a preoperative intraaortic balloon pump, 184 (2.4%) received an intraoperative intraaortic balloon pump, and 42 (0.56%) received a postoperative intraaortic balloon pump. Logistic European System for Cardiac Operative Risk Evaluation–derived predicted risk of death was higher across all intraaortic balloon pump groups compared with the group with no intraaortic balloon pump. Observed in-hospital mortality was significantly lower in the preoperative group (10%) and the group with no intraaortic balloon pump (0.8%) compared with the intraoperative (16%) and postoperative (29%) groups. Risk-adjusted mortality was also lower in the preoperative group.

Conclusion: This study comparing outcomes in patients undergoing cardiac surgical procedures with timing of intraaortic balloon pump placement revealed that the use of preoperative intraaortic balloon pumps was associated with a strong trend toward reduction in in-hospital mortality despite a higher predicted mortality in this group. The study provides support to the growing body of literature advocating preoperative use of intraaortic balloon pumps in carefully selected patients.
Crown Copyright © 2010 Published by Elsevier Inc. on behalf of The American Association for Thoracic Surgery
Keyword Risk coronary-patients
Pump support
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available ahead of print Nov 12, 2009. Published under "Acquired cardiovascular disease".

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 19 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 17 Mar 2011, 09:20:44 EST by Debbie Banks on behalf of !NON-HERDC