ABSTRACT
Background:Myxomas are the most common primary cardiac tumors that develop mostly at the atrial chambers of the heart and represent 0,25% of all cardiac diseases. Methods: This is a retrospective study aiming to analyze epidemiological and intraoperative data from cardiac myxoma cases in the hospital of the last 32 years. The study population was 145 cardiac surgical patients and was divided into 4 certain 8?year periods. 87,6% of cases had the myxoma located at left atrium and 97,2% of all patients fully recovered. 4,1% of patients relapsed and underwent a redo operation. Results: Mean CPB time and mean ICU length of stay increased during the 8?year periods (p < 0,001, P < 0,001, P = 0,002 and P = 0,003 respectively). In-hospital length of stay decreased to 5 days in the most recent period (p < 0,001). Cases significantly increased to 54 in the last 8?year period (p = 0,009). Conclusion: Improvement on cardiac imaging and a better accessibility may drive patients to earlier and safer diagnosis of myxomas preventing any deterioration of their condition. Improvement on postoperative care can also reduce in-hospital length of stay. Surgical excision is the treatment of choice and guaranteed survival at 97,2% of patients.
ABSTRACT
Readmission in the intensive care unit [CU] is a significant morbidity index, which has been related to poor patient outcomes. To identify the preoperative and intraoperative risk factors for readmission in the cardiac surgery ICU. We conducted a retrospective cohort study of 595 consecutive patients who were admitted to the cardiac surgery ICU of a tertiary hospital of Athens - Greece during the one-year period [September 2011-September 2012]. Data collection was carried out, retrospectively, by the use of a short questionnaire and based on the review of medical and nursing patient records at December 2012. The incidence of ICU readmission was 3.7% [22/595]. Respiratory disorders were the main reason for readmission [45.4%]. Readmitted patients had a significantly higher in-hospital mortality compared to those requiring no readmission [P< 0.001]. Multivariate analysis revealed that female gender [for males odds ratio [OR] 0.37, 95% confidence interval [Cl] 0.15-0.89], high logistic EuroSCORE [OR 1.02, 95% Cl 1.00-1.04], prolonged cardiopulmonary [CPB] duration [OR 1.01, 95% Cl 1.00-1.02] and preoperative renal failure [OR 1.02, 95% Cl 1.00-1.05] were the independent risk factors for readmission to the cardiac surgery ICU. One intraoperative and three preoperative variables are associated strongly with higher probability for ICU readmission. Shorter CPB duration could contribute to lower ICU readmission incidence. In addition, the early identification of high risk patients for readmission in the cardiac surgery ICU could encourage both the more efficient healthcare planning and resources allocation