The Value of Post Mortems in Cardiac Surgery: Learning from the Dead
ABSTRACT Little information is available regarding the role of post-mortem in cardiac surgery. The cause of death by clinical presumption can be misleading. The aim is evaluate the role of post-mortem following cardiac surgery by comparing clinically attributed causes of death versus post-mortem findings.
A total of 10,099 cardiac operations were performed over a seven-year period in a single institution in the United Kingdom. There were 363 (3.6%) deaths. The mean age at death was 71 with 66.7% male. Of these, 348 (95.9%) patients underwent a post-mortem examination.
There was a significant disparity between presumed and actual causes of death in 78 (22.4%) patients. The commonest unrecognised cause of death was cardiac causes (21 patients, 6.0%). The most overestimated cause of death was multi-organ failure, which was incorrectly diagnosed as the cause of death in 28 patients (8.0%).
Post-mortem can determine unsuspected diagnoses in a significant proportion of patients undergoing cardiac surgery. It plays an important role in cardiac surgery and remains essential for quality assessment in perioperative treatment.
- SourceAvailable from: Enrico Vizzardi[Show abstract] [Hide abstract]
ABSTRACT: Acute bowel ischemia is a perioperative complication that is frequently unrecognized as a cause of death after cardiac surgical procedures, with an in-hospital mortality of 50% to 100%. In recent years, controversy regarding the most appropriate approach to resolve clinical or laboratory suspicion and the limited therapeutic options have led to very little improvement in patient prognosis. This article reviews the related literature examining the actual prevalence, pathophysiologic mechanisms, predisposing factors, diagnostic tests, and therapeutic approaches providing a glance at new promising tools in diagnostic workup.The Annals of thoracic surgery 03/2014; DOI:10.1016/j.athoracsur.2014.01.029 · 3.65 Impact Factor