Cardiac Surgery, Heart Failure, Hepatic Impairment
Conditions
Keywords
MELD score, hemodynamics, liver abnormalities
Brief summary
The aim of the present study is the evaluation of the occurrence and effect of hepatic dysfunction on outcome following cardiac surgery, as well as the monitoring of changes in liver haemodynamics in the early postoperative period.
Detailed description
Prospective, consecutive study of patients undergoing cardiac surgery in Heart and Vascular Center, Semmelweis University, Budapest. Registered data: * Anamnestic and demographic data * Liver dysfunction prior surgery, etiology of liver dysfunction * Perioperative clinical data: laboratory tests, imaging, haemodynamic measures * risk prediction score of the American Society of Anesthesiologists(ASA), EUROpean System for Cardiac Operative Risk Evaluation (EuroScore), Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score (SAPS II), Canadian Cardiovascular Society grading of angina pectoris (CCS) * Model for End-Stage Liver Disease (MELD), MELD excluding International Normalised Ratio (INR) (MELD-XI), modified MELD score (modMELD), Child-Pugh The occurrence and etiology pattern of hepatic impairment are going to be evaluated according to age and type of cardiac illness. Correlations between perioperative haemodynamical alterations and structural, functional changes in hepatic status will be investigated. The impact of hepatic impairment on surgical outcome is going to be examined by multivariate regression models.
Interventions
None listed
Sponsors
Semmelweis University
Semmelweis University Heart and Vascular Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients over 18 years of age admitted for elective cardiac surgical procedures
Exclusion criteria
* Not willing to participate. * Pregnant women. * During active psychiatric hospital care. * Patients with defined legal incapability or limited capability. * Non-evaluable patient due to insufficient clinical information * Patients with a transplanted heart.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The composite of in-hospital death of any cause | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks |
| Length of hospital stay | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks |
| Length of ICU stay | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Evidence of clinically definite postoperative low cardiac output syndrome | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks |
| Evidence of clinically definite postoperative decline in hepatic function | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks |
| Evidence of clinically definite postoperative impaired coagulation | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks |
| Evidence of clinically definite postoperative acute kidney injury and the need for dialysis | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks |
| Need for reoperation due to bleeding or cardiac cause | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks |
| Evidence of clinically definite postoperative pulmonary or systemic congestion | Participants will be followed for the duration of hospital stay, an expected average of 2 weeks |
Countries
Hungary
Contacts
Primary ContactAndrea Székely, MD, PhD
Backup ContactEnikő Holndonner-Kirst, MD
Outcome results
None listed