30-day mortality after heart surgery poor parameters for success

Baltimore - Researchers at Johns Hopkins Hospital consider 30-day mortality after heart surgery to be questionable parameter to measure the success of the operation. The working group concluded this from statistically noticeable increase in mortality on the 30th postoperative day. They published their results in Health Services Research ().

30-day mortality after surgery is one of many factors surgeons use to measure the success of an operation. Postoperative complications such as thromboembolism or infections can increase the risk of death for the patient. The risk increases significantly, especially in the first few days after the operation. However, the study's researchers doubt whether the direct postoperative complications will be over after 30 days.

For their analysis, they used data from over 595,000 patients who underwent heart surgery in the USA between 2005 and 2009 . Most of the interventions consisted of heart valve replacement and bypass operations. In total, about 19,500 patients (3.27 percent) died in the hospital after surgery. The working group found that there were two noticeable peaks in mortality after the operation.

The first of them showed up on the sixth and the second on day 30 postoperative day. The mortality on the 30th postoperative day was one percent, while in the previous week the mortality on each day varied between 0.63 and 0.81 percent. Overall, the increase on day 30 was 35 percent.

According to the scientists, this was the strongest relative increase they observed in the postoperative period (60 days). While the increased mortality on the sixth day after surgery due to possible organic complications seems plausible, the working group had no direct explanation for the peak on the 30th day.

The timing of medical interventions and decisions about the continuation of aggressive medical therapies could according to the researchers, possible reasons for the increase. Because of these uncertainties, Maxwell sees the possibility of returning home or the everyday resilience of the patient as much more suitable criteria for measuring the success of heart surgery.