Cirugía cardiaca en Costa Rica: caracterización de los pacientes en el Hospital San Juan de Dios del 2010 al 2015

Abstract

Introduction and objectivesIn Costa Rica there is limited literature on cardiac surgery. This pioneering study in the country characterizes, clinically and sociodemographically, patients who underwent cardiac surgery at Hospital San Juan de Dios, with the aim of communicating to the scientific community the results of this center in the context of Costa Rica's Social Security. The study also aims to identify risk factors that affect global mortality and thereby optimize patients’ perioperative care. MethodsObservational, retrospective study, from the Cardiac Surgery Department database at Hospital San Juan de Dios, between January 2010 and December 2015. Clinical history, surgical and hospital evolution variables were recorded and statistically analyzed. Results692 patients, male predominance (63.9%); mean age 57.1 ± 13.9 years; at least one postoperative complication in 41% and mortality of 14.9%. Surgical distribution: valvular (47.8%), coronary artery bypass grafting (31.5%), ascending aorta and arch (6.9%), combined coronary artery bypass grafting - valvular (5.8%), adult congenital heart disease (4.2%), and cardiac miscellaneous (3.8%). EuroSCORE, preoperative B-type natriuretic peptide and New York Heart Association functional scale resulted in mortality predictors. Inflection points for mortality: 250 pg/mL for preoperative B-type natriuretic peptide, 149min for extracorporeal circulation time and 84min for aortic clamping time. ConclusionsThrough this characterization study of patients who underwent cardiac surgery during the period between 2010 and 2015, it is possible to evaluate the performance of the Department at Hospital San Juan de Dios, which is essential for analysis and improvement of quality of surgical treatment provided to patients with cardiac pathology within Costa Rica's Social Security System.