Risk assessment for postoperative complications in patients undergoing cardiac surgical procedures

Rev Bras Enferm. 2024 Sep 20;77(4):e20230127. doi: 10.1590/0034-7167-2023-0127. eCollection 2024.
[Article in English, Portuguese]

Abstract

Objectives: to evaluate the risk of postoperative complications in cardiac patients.

Methods: an evaluative study using the Tuman Score on medical records of 70 adult patients who underwent cardiac surgery at a University Hospital. The R for Windows software was used for the analyses. Descriptive statistics and bivariate analysis were employed to verify the association between the risk score and complications. The relative risk between the Tuman Score and postoperative complications was obtained through Quasi-Poisson regression, with a 95% confidence interval.

Results: the majority of the patients were male (58.57%), aged between 41-64 years (50%), who underwent myocardial revascularization (50%). These patients were associated with a lower risk of postoperative complications (p=0.003), (p=0.008), and (p=0.000), respectively. High-risk patients had pulmonary complications (RR=1.32, p=0.002) and neurological complications (RR=1.20, p=0.047).

Conclusions: preoperative risk assessment promotes qualified care to reduce postoperative complications.

Objetivos:: evaluar el riesgo de complicaciones posoperatorias en pacientes cardíacos.

Métodos:: investigación evaluativa, utilizando el Escore de Tuman, en historiales médicos de 70 pacientes adultos sometidos a cirugía cardíaca en un Hospital Universitario. Se utilizó el software R for Windows para los análisis. Se emplearon estadísticas descriptivas y análisis bivariados para verificar la asociación entre el escore de riesgo y las complicaciones. El riesgo relativo entre el Escore de Tuman y las complicaciones posoperatorias se obtuvo mediante regresión Quasi-Poisson, con un intervalo de confianza del 95%.

Resultados:: predominaron los pacientes del sexo masculino (58.57%), con edades entre 41 y 64 años (50%), que se sometieron a Revascularización del Miocardio (50%), y estos estuvieron asociados con un menor riesgo de complicaciones posoperatorias (p=0,003), (p=0,008) y (p=0,000), respectivamente. Los pacientes de alto riesgo tuvieron complicaciones pulmonares (RR=1,32 y p=0,002) y complicaciones neurológicas (RR=1,20 y p=0,047).

Conclusiones:: la evaluación de los riesgos preoperatorios promueve una atención de calidad para reducir las complicaciones posoperatorias.

MeSH terms

  • Adult
  • Aged
  • Cardiac Surgical Procedures* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data
  • Risk Factors