Abstract
Abstract Background Although cardiovascular disease is the leading cause of death in women, few data exist on risk factors and treatment of these diseases in women. This leads to a delay in the institution of appropriate therapies and worse outcomes in this population. Objective We aimed to identify predictors of morbidity and mortality in women undergoing isolated mitral valve replacement. Methods This was a retrospective cohort study with 104 women who underwent isolated mitral valve replacement at a referral hospital for treatment of cardiovascular diseases, performed from January 2011 to December 2016. Data were obtained from medical records. Statistical analysis was performed to calculate odds ratio, unpaired Student's t-test, and binary logistic regression. P values <0.05 were considered statistically significant. Results Mean age of patients was 43.73 (±13.85) years. Most patients had a diagnosis of rheumatic disease prior to surgery (76%; N=79). Mortality rate was 4.9% (N = 5). There was a statistically higher risk of death among patients with reduced ejection fraction (EF) (<50%) (OR = 14.833, 95% CI 2.183 - 100.778, P=0.001) and older age (P = 0.009). There was an inverse association between a previous diagnosis of rheumatic disease and death (OR = 0.064, 95% CI 0.007 - 0.606, P=0.002). Logistic regression showed reduced EF at preoperative evaluation as a predictor of death and a diagnosis of rheumatic disease as a protective factor. Conclusion Older age and reduced EF were associated with postoperative mortality. Reduced EF was a predictor of death, and rheumatic disease was associated with better surgical outcomes.
Highlights
Cardiovascular disease (CVD) is the leading cause of death in developed countries[1] and, in Brazil, despite regional differences, CVD kills more than any other cause.[2]
The purpose of this article was to identify preoperative, intraoperative, and postoperative risk factors for morbidity and mortality in a Brazilian female group of patients who underwent isolated mitral valve replacement, to obtain pertinent information regarding the current scenario in Brazil and contribute to a more gender-specific and individualized treatment of women
This was a retrospective cohort study that analyzed the medical records of patients who underwent isolated mitral valve replacement at a referral center for treatment of cardiovascular diseases located in the city of Salvador (Bahia, Brazil)
Summary
Cardiovascular disease (CVD) is the leading cause of death in developed countries[1] and, in Brazil, despite regional differences, CVD kills more than any other cause.[2]. There are few data in the literature about the assessment of risk factors and treatment of CVDs in women, as compared to men, including in Brazil. Cardiovascular disease is the leading cause of death in women, few data exist on risk factors and treatment of these diseases in women. This leads to a delay in the institution of appropriate therapies and worse outcomes in this population. Logistic regression showed reduced EF at preoperative evaluation as a predictor of death and a diagnosis of rheumatic disease as a protective factor.
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