Abstract
IntroductionThe outcomes of Jehovah's Witness (JW) patients submitted to open heart surgery may vary across countries and communities. The aim of this study was to describe the morbidity and mortality of JW patients undergoing cardiac surgery in a tertiary hospital center in Southern Brazil.MethodsA case-control study was conducted including all JW patients submitted to cardiac surgery from 2008 to 2016. Three consecutive surgical non-JW controls were matched to each selected JW patient. The preoperative risk of death was estimated through the mean EuroSCORE II.ResultsWe studied 16 JW patients with a mean age of 60.6±12.1 years. The non-JW group included 48 patients with a mean age of 63.3±11.1 years (P=0.416). Isolated coronary artery bypass graft surgery was the most frequent surgery performed in both groups. Median EuroSCORE II was 1.29 (IQR: 0.66-3.08) and 1.43 (IQR: 0.72-2.63), respectively (P=0.988). The mortality tended to be higher in JW patients (18.8% vs. 4.2%, P=0.095), and there was a higher difference between the predicted and observed mortality in JW patients compared with controls (4.1 and 18.8% vs. 2.1 and 4.2%). More JW patients needed hemodialysis in the postoperative period (20.0 vs. 2.1%, P=0.039).ConclusionWe showed a high rate of in-hospital mortality in JW patients submitted to cardiac surgery. The EuroSCORE II may underestimate the surgical risk in these patients.
Highlights
The outcomes of Jehovah's Witness (JW) patients submitted to open heart surgery may vary across countries and communities
The mortality tended to be higher in JW patients (18.8% vs. 4.2%, P=0.095), and there was a higher difference between the predicted and observed mortality in JW patients compared with controls (4.1 and 18.8% vs. 2.1 and 4.2%)
We showed a high rate of in-hospital mortality in JW patients submitted to cardiac surgery
Summary
The outcomes of Jehovah's Witness (JW) patients submitted to open heart surgery may vary across countries and communities. Despite the development in surgical techniques, more than 50% of patients receive perioperative transfusion in cardiac surgeries[1]. The data of case series[2,3,4,5,6] and some controlled studies[7,8,9,10] showed that the perioperative and postoperative prognosis of JW is similar to those of patients who do not have restrictions to blood products transfusions. The rates of mortality and postoperative complications in patients that undergo cardiac surgery are variable. Clinical results are determined largely by sample characteristics and by the preoperative and postoperative care, assistant teams cultural and religious factors may play a specific role in the surgical success of these patients. The evaluation of the cardiac surgery results in JW patients should be evaluated in different cultural scenarios
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