Cardiac surgery patients did not have increased mortality compared to what is expected for people their age.
The thesis of Tone Bull Enger of NTNU shows excellent long-term survival following cardiac surgery, but mortality is higher than expected in women and younger patients. Her research also identifies genetic and circulating risk factors associated with increased risk of complications following cardiac surgery.
The first two studies include more than 1,000 patients that underwent cardiac surgery with cardiopulmonal bypass at St. Olavs University Hospital in Trondheim. A common SNP in the UMOD gene was associated with increased risk of fluid overload following surgery. The SNP has previoulsy been related to kidney function. Bull Enger and colleagues also identified NT-proBNP, neopterin and low levels of lactoferrin as independent risk markers of post-operative acute kidney disease. Addition of these three biomarkers to a clinical risk model resulted in slightly better risk prediction.
Among 8,564 cardiac surgery patients, 86,9 % were still alive five years after surgery and 69,3 % were alive after ten years. The survival was comparable to that expected in the general Norwegian population. However, in women, patients younger than 70 years of age, and patients that underwent valve surgery, the long-term mortality was higher than expected.
Thesis: Risk factors for short- and long-term complications following adult cardiac surgery
Candidate: Tone Bull Enger
Time and place: March 31, 2017, St. Olavs University Hospital, Trondheim
Enger, T. B., Pleym, H., Stenseth, R., Wahba, A., & Videm, V. (2014). Genetic and clinical risk factors for fluid overload following open‐heart surgery. Acta Anaesthesiologica Scandinavica, 58(5), 539-548.
Enger, T. B., Pleym, H., Stenseth, R., Greiff, G., Wahba, A., & Videm, V. (2016). Reduced Long-Term Relative Survival in Females and Younger Adults Undergoing Cardiac Surgery: A Prospective Cohort Study. PloS one, 11(9), e0163754.
Enger, T. B., Pleym, H., Stenseth, R., Greiff, G., Wahba, A., & Videm, V. (2016). A Preoperative Multimarker Approach to Evaluate Acute Kidney Injury After Cardiac Surgery. Journal of Cardiothoracic and Vascular Anesthesia.