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Age and other perioperative risk factors for postoperative systemic inflammatory response syndrome after cardiac surgery.
Dieleman, J M; Peelen, L M; Coulson, T G; Tran, L; Reid, C M; Smith, J A; Myles, P S; Pilcher, D.
Afiliación
  • Dieleman JM; Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia.
  • Peelen LM; Department of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, The Netherlands.
  • Coulson TG; Department of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, The Netherlands.
  • Tran L; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
  • Reid CM; Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia.
  • Smith JA; Department of Intensive Care, The Alfred Hospital, Melbourne, Victoria, Australia.
  • Myles PS; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Pilcher D; ANZSCTS Cardiac Surgical Database, Melbourne, Victoria, Australia.
Br J Anaesth ; 119(4): 637-644, 2017 Oct 01.
Article en En | MEDLINE | ID: mdl-29121297
BACKGROUND: The inflammatory response to surgery varies considerably between individual patients. Age might be a substantial factor in this variability. Our objective was to examine the association of patient age and other potential risk factors with the occurrence of a postoperative systemic inflammatory response syndrome, during the first 24 h after cardiac surgery. METHODS: This was a retrospective cohort study, using linked data from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) Database and the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database. Data from patients who underwent coronary artery bypass grafting and/or valve surgery were used. The association between age and postoperative SIRS was analysed using Poisson regression, and corrected for other risk factors. Restricted cubic splines were used to determine relevant age categories. Results are expressed as risk ratios (RR) with 95% confidence intervals (CI). RESULTS: Data from 28 513 patients were used. In both univariable and multivariable models, increased patient age was strongly associated with reduced postoperative SIRS prevalence. Using 73-83 yr as the reference category, the RRs (95% CI) for the age categories were 1.38 (1.28-1.49) for ≤43 yr, 1.15 (1.09-1.20) for 44-63 yr, 1.05 (1.00-1.09) for 64-72 yr, and 1.03 (0.94-1.12) for >83 yr, respectively. The predictive value for postoperative SIRS of the final model, however, was moderate (c-statistic: 0.61). CONCLUSIONS: We have demonstrated that advanced patient age is associated with a decreased risk of postoperative SIRS among cardiac surgery patients, where patients aged over 72 yr had the lowest risk.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Respuesta Inflamatoria Sistémica / Procedimientos Quirúrgicos Cardíacos Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Oceania Idioma: En Revista: Br J Anaesth Año: 2017 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Respuesta Inflamatoria Sistémica / Procedimientos Quirúrgicos Cardíacos Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Oceania Idioma: En Revista: Br J Anaesth Año: 2017 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido