Abstract:
OBJECTIVE:To examine the role of the CHA2DS2-VASc (Congestive heart failure; Hypertension; Age ≥75 years [doubled]; Diabetes; previous Stroke, transient ischemic attack, or thromboembolism [doubled]; Vascular disease; Age 65-75 years; and Sex category) score as a prognostic marker of in-hospital mortality in critically ill patients who develop new-onset atrial fibrillation (NOAF). DESIGN:Retrospective analyses. SETTING:A single-center study in a tertiary care academic medical center. PARTICIPANTS:The study comprised all adult patients with NOAF admitted to noncardiac intensive care units (ICUs) at a tertiary care academic institution between January 2009 and March 2016. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:The authors retrospectively reviewed electronic medical records of all adult patients admitted to noncardiac ICUs at a tertiary care academic institution between January 2009 and March 2016. Patients with NOAF were identified and their CHA2DS2-VASc score was calculated. The authors evaluated the association of CHA2DS2-VASc score and its individual components with in-hospital mortality in these patients. A total of 640 (1.7% [38,708 patients]; 95% CI 1.5%-1.8%) patients developed NOAF during the study period. The in-hospital mortality rate in patients included in the analysis was 14.3%. There was no association between in-hospital mortality and CHA2DS2VASc score. However, the likelihood of in-hospital death was 1.56 times greater for patients having atrial fibrillation and concomitant vascular disease (95% CI 1.003-2.429; p = 0.049). CONCLUSIONS:New-onset atrial fibrillation is common in critically ill patients and is associated with high in-hospital mortality. The authors found that the CHA2DS2-VASc score itself is not a reliable prognostic marker of in-hospital mortality in these patients. However, the presence of vascular disease in patients with NOAF may increase the mortality associated with this disease.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Karamchandani K,Schoaps RS,Abendroth T,Carr ZJ,King TS,Bonavia Adoi
10.1053/j.jvca.2019.11.044subject
Has Abstractpub_date
2020-05-01 00:00:00pages
1165-1171issue
5eissn
1053-0770issn
1532-8422pii
S1053-0770(19)31217-0journal_volume
34pub_type
杂志文章abstract:OBJECTIVE:To assess the association between postoperative central venous oxygen saturation (ScvO(2)) and arterial lactate with outcome after cardiac surgery. DESIGN:Prospective observational study. SETTING:University-affiliated tertiary care hospital. PARTICIPANTS:Patients after coronary artery bypass and/or valve s...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2011.07.021
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the success and complication rates of a single center's multidisciplinary approach to transvenous lead extraction. SETTING:One university hospital. PARTICIPANTS:One hundred ninety-five patients scheduled for transvenous lead extraction. INTERVENTIONS:A multidisciplinary approach to transvenous ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.11.010
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:The authors tested the hypothesis that patients with metabolic syndrome are more likely to develop short-term cognitive dysfunction after cardiac surgery with cardiopulmonary bypass. DESIGN:A prospective study. SETTING:Veterans Affairs medical center. PARTICIPANTS:Fifty-six age- and education-balanced pati...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.06.008
更新日期:2011-04-01 00:00:00
abstract::A pulmonary artery catheter (PAC) capable of continuous cardiac output (CCO) determination by thermodilution has recently been introduced. The purpose of this study was to compare CCO with two other methods of cardiac output (Ot) determination: electromagnetometry (EM) and standard bolus thermodilution cardiac output ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(94)90193-7
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:Extracorporeal cardiopulmonary resuscitation (eCPR) with venoarterial extracorporeal membrane oxygenation (VA-ECMO) is gaining importance as a rescue therapy for refractory cardiac arrest. VA-ECMO, especially in the setting of eCPR, is plagued by hemorrhagic and thromboembolic complications. The authors' aims...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.11.014
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:To investigate sedation and anesthesia trends and practice patterns for procedures in the cardiac electrophysiology laboratory (EPL). DESIGN:A survey distributed by e-mail. SETTING:US teaching hospitals with a training program in cardiac electrophysiology. PARTICIPANTS:Cardiologists involved in procedures ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.11.006
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:Pulmonary resection may be associated with considerable alterations of the cardiorespiratory system. The ideal anesthetic regimen for these patients is not yet definitely determined. DESIGN:Prospective, randomized study. SETTING:Single-institutional, clinical investigation in a thoracic anesthesia departmen...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1053-0770(96)80045-0
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to test the hypothesis that normothermic cardiopulmonary bypass (CPB) is as effective as hypothermic CPB in terms of cardiac protection (cTnI level) and outcome in patients with valvular heart disease. DESIGN:Prospective randomized study. SETTING:A tertiary cardiothoracic referral ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2013.03.009
更新日期:2014-04-01 00:00:00
abstract::Inadvertent postoperative hypothermia in the cardiac surgical patient can have various adverse physiologic effects. Previous studies have investigated the relationship of patient, surgical, and anesthetic factors with postoperative hypothermia in patients undergoing noncardiac surgery. This study was designed to asses...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80186-7
更新日期:1995-04-01 00:00:00
abstract::Tissue edema, in particular pulmonary edema, increasingly is recognized as a perioperative complication affecting outcome. Management strategies directed at avoiding excessive fluid administration, reducing inflammatory response, and decreasing capillary permeability commonly are advocated in perioperative care protoc...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2017.02.018
更新日期:2017-08-01 00:00:00
abstract::In the UK, mortality rate during pregnancy/in the peripartal period is 14.1 per 100,000 maternities with heart disease being the leading cause of non-obstetric maternal mortality (10% to 15% of all maternal deaths). Owing to the advances in the treatment of congenital heart disease (CHD), an increasing percentage of w...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.12.021
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To assess the effect of systemic vascular resistance (SVR) on the reliability of the ClearSight system (Edwards Lifesciences, Irvine, CA) for measuring blood pressure (BP) and cardiac output (CO). DESIGN:Observational study. SETTING:University hospital. PARTICIPANTS:Twenty-five patients undergoing cardiac ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.11.011
更新日期:2020-11-12 00:00:00
abstract::Left atrial or pulmonary capillary wedge pressure V waves are used immediately after mitral valve replacement to evaluate valve competence. However, their correlation with hemodynamically significant regurgitation has not been established. Transesophageal echocardiography (TEE) was used to prospectively examine whethe...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(91)90035-r
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVES:During cardiac surgery, circulating red blood cells (RBCs) are at risk of exposure to environmental factors during extracorporeal circulation and transfusion of stored RBCs. For this study, the authors observed morphological differences, deformability, density distribution, and erythrocyte indices of RBCs du...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.03.030
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:This study compared the efficacy of aminocaproic acid and tranexamic acid in reducing postoperative blood loss, as well as blood and blood product requirements in children with cyanotic congenital heart disease. DESIGN:A prospective randomized study. SETTING:Cardiac center of a tertiary care, referral hospi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/j.jvca.2004.01.016
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:There has been controversy regarding the beneficial effects of calcium on myocardial contractility and the harmful effects on myocardial cells, especially in children. The aim of this study was to investigate an association between ionized calcium concentration (iCa) and outcomes for pediatric patients after ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2017.11.006
更新日期:2018-08-01 00:00:00
abstract::Twenty-three informed and consenting patients scheduled for CABG were anesthetized using computer-controlled infusions of alfentanil, midazolam, and pancuronium. Thirteen middle-aged patients received a preprogrammed infusion scheme of alfentanil, simulated using the population pharmacokinetic set of Maitre et al (Gro...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/1053-0770(94)90238-0
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVE:The long-term use of milrinone is associated with increased mortality in chronic heart failure. A recent meta-analysis suggested that it might increase mortality in patients undergoing cardiac surgery. The authors conducted an updated meta-analysis of randomized trials in patients undergoing cardiac surgery t...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.jvca.2012.08.005
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:Patients undergoing transapical cardiac procedure are a minority of cardiac surgery patients but represent a challenge for cardiac anesthesiologists because they generally are older and have more comorbidities than do open heart cardiac surgery patients. The aims of this study were to describe the anesthetic ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.10.039
更新日期:2019-07-01 00:00:00
abstract::Currently, hemostasis is one of the most widely researched topics in perioperative medicine. As investigators learn more about the complexity of coagulation, developing tests with the ability to rapidly monitor coagulation and guide targeted therapy is the key to optimizing hemostasis management. There is mounting evi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2017.05.037
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:To investigate whether the Edmonton Frail Scale (EFS), a multidimensional frailty assessment tool, improves the prediction of 30-day or in-hospital mortality over the use of the European System for Cardiac Outcome Risk Evaluation (EuroSCORE) II alone. DESIGN:Single-center prospective observational study. S...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.05.038
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:The authors hypothesized that bioimpedance cardiography measured by the Endotracheal Cardiac Output Monitor (ECOM; ConMed, Utica, NY) is a convenient and reliable method for both cardiac index (CI) assessment and prediction in fluid responsiveness. DESIGN:A prospective observational study. SETTING:A teachi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2011.06.023
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate whether acute kidney injury (AKI) after coronary artery bypass grafting can be attributed to intraoperative hypotension during cardiopulmonary bypass (IOH-CPB). DESIGN:Retrospective analysis. SETTING:Tertiary-care hospital. PARTICIPANTS:Patients undergoing on-pump c...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.07.040
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:This study was designed to determine whether ropivacaine plus fentanyl was as effective as bupivacaine plus fentanyl in a continuous thoracic paravertebral block after posterolateral thoracotomy. DESIGN:Patients were randomly assigned in a blinded fashion to receive 1 of 2 solutions for paravertebral analges...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2006.02.032
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:To study the influence of preoperative warfarin anticoagulation on postoperative blood loss and allogeneic blood requirement. DESIGN:Retrospective study with a matched control group. SETTING:University and community hospital, single institutional. PARTICIPANTS:240 patients scheduled for cardiac surgery. I...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80316-7
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:Postoperative atrial tachyarrhythmias (POATs) after coronary artery bypass grafting (CABG) are reported in 11% to 40% of patients. Several etiologic factors are mentioned. Prophylactic intervention with sotalol is reported to reduce the incidence of POAT. The authors studied the effect of magnesium chloride (...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/j.jvca.2004.03.010
更新日期:2004-06-01 00:00:00
abstract::Of the 3,231 thoracic procedures performed between July 1, 1994, and June 30, 1996, 8.9% of patients were ventilated postoperatively; 3.1% required an intensive care unit (ICU) stay of a median of 8 days. Of those patients admitted to the ICU, 29% died; 10% of patients requiring postoperative ventilation were subseque...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:The authors conducted a review of randomized controlled trials to identify advantages in clinically relevant outcomes in patients undergoing cardiac surgery with remifentanil. DESIGN:Meta-analysis. SETTING:Hospitals. PARTICIPANTS:A total of 1,473 patients from 16 randomized trials. INTERVENTIONS:None. ME...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.jvca.2011.05.007
更新日期:2012-02-01 00:00:00
abstract::This study investigated whether the prophylactic administration of methylprednisolone sodium succinate (MPSS) could prevent an increase in plasma endotoxin levels during cardiac surgery with cardiopulmonary bypass. MPSS (1 g/patient) or saline was given intravenously with induction in the steroid (n = 6) and control (...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/1053-0770(93)90113-y
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:The actions of volatile anesthetics on left ventricular (LV) function in normal and failing hearts have been previously evaluated, but the effects of these agents on left atrial (LA) function in the presence of LV dysfunction are unknown. The hypothesis was tested that isoflurane alters LA mechanics evaluated...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2003.09.006
更新日期:2003-12-01 00:00:00