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Prognostic factors of hospital mortality for unplanned re-exploration after cardiovascular surgery

Objective To explore the prognostic factors of hospital mortality for
unplanned re-exploration after cardiovascular surgery. Methods We
retrospectively analyzed the data of 100 patients who underwent
unplanned re-exploration after cardiovascular surgery in our hospital
between May 2010 and May 2020. There were 77 males and 23 females, aged
(55.1±15.2) years. Demographic characteristics, operation information,
perioperative complications were collected to set up a database. The
patients were divided into survival group and non-survival group
according to hospital mortality. Logistic regression was used for
multivariable analysis to explore the prognostic factors of hospital
mortality. These statistically significant indicators were selected for
drawing the receiver operating characteristic curve of the evaluation
model, calculating the area under the curve(AUC) and evaluating the
effectiveness of the new model with Hosmer-Lemeshow C-statistic. Results
Hospital mortality was 26.0% (26/100). Multivariate logistics
regression revealed that the operation time of unplanned re-exploration,
the worst blood creatinine within 48h before the re-exploration, the
worst lactate within 24h after the re-exploration, cardiac
insufficiency, respiratory insufficiency, and acute kidney injury were
independent prognostic factors (p<0.05). The AUC of the new
assessment model constituted by these prognostic factors was 0.910, and
the Hosmer-Lemeshow C-statistic was 4.153 (P= 0.762). Conclusions The
operation time of unplanned re-exploration, the worst blood creatinine
value within 48h before the re-exploration, the worst lactate value
within 24h after the re-exploration, cardiac insufficiency, respiratory
insufficiency, and acute kidney injury were independent prognostic
factors of hospital mortality for unplanned re-exploratio after
cardiovascular surgery.