Factores de riesgo de eventos adversos mayores en la cirugía de revascularización miocárdica Risk factors of major adverse events in myocardial revascularization surgery

INTRODUCCIÓN. La cirugía de revascularización miocárdica es la más frecuente de las cirugías cardíacas. Para conocer la prevalencia de eventos adversos mayores en esta cirugía y sus factores de riesgo, se estudiaron prospectivamente 1264 pacientes revascularizados consecutivamente entre enero de 1990 y del 2006 en el Instituto de Cardiología de La Habana. MÉTODOS. Se realizó un análisis multivariado de las variables de riesgo. Se obtuvieron las probabilidades de Bayes. El nivel de significación estadística fue de p INTRODUCTION. Myocardial revascularization surgery is the most common of heart surgeries.To know the prevalence of major adverse events in this surgery and their risk factors, 1264 patients that were consecutively revascularized were prospectively studied between January 1990 and January 1996 in the Cardiology Institute of Havana City. METHODS. A multivariate analysis of the risk variables was made. Bayes' probabilities were obtained. The statistical significance level was p < 0.05. RESULTS. Major events were reported in 398 cases (32.1 %). The most frequent events were surgical reintervention (234; 18.9 %) and low cardiac output (190; 15.0 %). Most of Bayes' positive probabilities for the appearance of adverse events behaved as follows: left ventricular ejection fraction < 40 % (probability: 66.2 %) and peripheral arterial vascular insufficiency (probability: 58.8 %) (preoperative); low cardiac output (probability: 82.3 %) and surgical accidents (probability: 73.1 %) (transoperative); non-sinusal rhythms (probability: 88.9 %) and use of four or more units of hemoderivatives (probability: 59.6 %) (postoperative). CONCLUSIONS. The adverse events behaved according to the ranges reported at the international level