Keywords
Urgent reexploration
Surgery
Emergencies
How to Cite
Abstract
Rescan emergency cardiovascular surgery service Ameijeiras Brothers Hospital between 2008 and 2009.Introduction: approximately between 5% and 10% of the subjected patients to cardiovascular surgery require of an urgent reexploratión.It is the postoperative bleeding the first cause of reintervention of urgency in an operated patient of cardiovascular surgery. The presentwork seeks to show the behavior of the reexploratión in operated patients of heart surgery in the service and to determine which themain factors of risk were associated to this to proceed as well as the evolution and the behavior of the costs. Objective: determinethe risk factors of emergency reintervention in cardiovascular surgery and to evaluate the hospital costs of reintervention. Materialsand Methods: it was performed a retrospective case-control study (cases n=47, controls n=916) in the Cardiovascular Surgery Serviceof the Hospital “Hermanos Ameijeiras” on the period between January 2008 and December 2009. We compared variables such as: age,sex, weight, height, background, preoperative medication, use of blood and blood products, hours of mechanical ventilation, hospitalstay, development, mortality and hospital costs. Results: we found predisposing factors such as male gender, ischemic cardiomyopathy,rheumatic fever, infective endocarditis, hepatopathies, history of stroke and elevated creatinine levels.Preoperative intake of diuretics,anticoagulants and antiplatelet agents was associated with an increased number of reinterventions. Reintervention was associated withincreased consumption of blood and blood products, longer cardiopulmonary bypass, longer mechanical ventilation, increasedUCIQ andHospital stay, higher rate of infections, increased mortality and increasedcosts. 81% of the reoperations did not have a surgical cause.Conclusions: there is a set of parameters that act as risk factors for emergency reintervention. Reoperated patients had higher morbidityand mortality, and represented a greater cost to the health system. The use of a thromboelastograph would represent an annual savingof $ 350 000.(MÉD.UIS. 2012;25(1):11-7).
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