Mortality in patients supported by intra-aortic balloon pump in the course of cardiac surgery was related to perioperative myocardial infarction

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Abstract
OBJECTIVE: To search for predictors of mortality for patients in need ofintra-aortic balloon pump (IABP) support in the course of cardiac surgery.METHODS: A retrospective study of possible pre- and perioperative riskfactors in 110 patients with mean age of 62 years (38-79). The IABP wasinserted preoperatively in 19 (17%) and perioperatively in 91 (83%).RESULTS: Well known risk factors as advanced age (63.2/61.0; P = 0.25),NYHA functional class (OR = 1.59; 95% CI 0.23 to 13.31), female sex (OR =2.40; 95% CI 0.81 to 6.73), emergency surgery (OR = 0.63; 95% CI 0.21 to1.80), low left ventricular ejection fraction (62.9/60.7; P = 0.53), orelevated end diastolic pressure (19.4/21.0; P = 0.48), were not prognosticof death. Perioperative insertion of the balloon pump (OR = 3.83; 95% CI1.07 to 14.95), perioperative myocardial infarction (OR = 23.3; 95% CI 7.62to 81.8), low cardiac output (OR = 7.53; 95% CI 2.43 to 24.11), and renalfailure (OR = 20.00; 95% CI 3.63 to 145), were strong predictors of death.CONCLUSIONS: Outcome seemed to be determined by perioperative events ratherthan preoperative risk factors. This could possibly explain the favourablemortality rates seen in patients on IABP support prior to surgery comparedto patients who had IABP installed perioperatively.

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