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Factors affecting in-hospital mortality and likelihood of undergoing surgical resection in patients with primary cardiac tumors.

Abstract：

BACKGROUND:Previous studies on primary cardiac tumors were mainly based on small case series collected from a limited number of institutions. Contemporary data of patients with primary cardiac tumors treated with or without surgery in a nationwide clinical setting are limited. METHODS:Using the Diagnosis Procedure Combination database, we retrospectively identified 1317 patients hospitalized with a primary cardiac tumor (1023 myxomas, 63 non-myxomas, 72 sarcomas, 41 malignant lymphoma, 118 unspecified tumors) at 486 hospitals in Japan from July 2010 to March 2013. The outcome was overall in-hospital mortality, defined as in-hospital death occurring during the initial hospitalization or during rehospitalization. We examined the associations of baseline factors with overall in-hospital mortality and undergoing surgical resection using multivariable logistic regression analyses. RESULTS:Overall, 914 (69.4%) patients underwent surgery and 403 (30.6%) did not. The surgery group was younger (median age, 67 years vs. 71 years, p<0.001) and was more likely to be treated at an academic hospital (38.9% vs. 27.8%, p<0.001) than the no-surgery group. The surgery group also had a higher Barthel index and a higher conscious level and showed a lower frequency of extracardiac malignancies than the no-surgery group. The likelihood of undergoing surgery was associated with coexisting cerebral infarction [adjusted odds ratio (95% confidence interval), 1.96 (1.23-3.12)] and academic hospital [1.58 (1.20-2.09)]. Patients with lower Barthel index and coexisting extracardiac malignancies were less likely to undergo surgery. Overall in-hospital mortality was 2.1% and 13.4% in the surgery and non-surgery groups, respectively. Older age, lower Barthel index, lower consciousness level, coexisting metastatic extracardiac malignancy [2.95 (1.24-7.01)], and sarcoma [21.04 (8.28-53.42)] were associated with higher overall in-hospital mortality, while academic hospital [0.41 (0.20-0.84)] and surgical resection [0.39 (0.20-0.74)] were associated with lower mortality. CONCLUSIONS:Several background factors were associated with prognosis and surgery in patients hospitalized with primary cardiac tumors.

journal_name

J Cardiol

journal_title

Journal of cardiology

authors

Isogai T,Yasunaga H,Matsui H,Tanaka H,Hisagi M,Fushimi K

doi

10.1016/j.jjcc.2016.05.008

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

287-292

issue

eissn

0914-5087

issn

1876-4738

pii

S0914-5087(16)30091-0

journal_volume

pub_type

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Factors affecting in-hospital mortality and likelihood of undergoing surgical resection in patients with primary cardiac tumors.