The Correlation Analysis Of Cause-of-death In Cardiac Surgery Patients During Postoperative Period And Risk Factors Of Euroscore Ⅱ

Objective: Cardiac surgery is recognized as a high-risk operation due to the particularity of the surgical object and the complexity of the surgical operation.Severe complications often occur after surgery,resulting in prolonged residence time,increased costs and even death of the patient.Risk assessment and discussion and analysis of the causes of death of postoperative patients have important clinical application value.Euro SCORE Ⅱ is recognized internationally for its positive effects and is widely used in risk assessment models for cardiac surgery.This study intends to verify the correlation between various risk factors in Euro SCOREⅡ and the causes of death in cardiac surgery patients,and analyze the various causes of death and risk factors in in cardiac surgery patients to provide a reference for clinical diagnosis and treatment.Methods: A total of 132 cardiac surgery patients in our center from January2014 to December 2018 and died within 30 days after surgery or in the postoperative hospital were selected as the research subjects,retrospectively analyze and sort out the death cases and discuss the analysis results to get various causes of death of patients.Use statistical methods to test the correlation between the cause of death and various risk factors in Euro SCOREⅡ.Results: The average age of patients was 63.52 ± 12.39 years old,including 74 male patients(56.1%),58 female patients(43.9%),and 87patients(65.9%)older than 60 years old.31 patients(23.5%)had simple coronary artery bypass surgery,9 patients(6.8%)had simple valve replacement or repair,5 patients(3.8%)had single valve plus coronary artery bypass surgery,and 87 patients(66.0%)had complicated combined surgery or acute aorta dissection surgery.The possible cause of death of the patient is not single,and most of them are caused by two or more causes of perioperative death.The causes of death are roughly divided into three categories,which are cardiogenic and brain-derived causes(59.1%),infections and organ failure Source cause(55.3%)and accidental death(16.0%).Cardiogenic and brain-derived causes include postoperative low cardiac output(28.0%),malignant arrhythmia(16.0%),perioperative myocardial infarction(1.5%),stroke(16.7%)and heart rupture(7.5%)The causes of infection and organ failure include multiple organ failure(41.7%),pulmonary infection(29.5%),mediastinal infection(5.3%)and septic shock(12.1%);accidental conditions include asphyxia(3.8%)),Intestinal obstruction(3.0%),gastrointestinal bleeding(13.6%)and allergic reactions(1.5%),some of the causes of postoperative death are related to 1 to 4 factors in Euro SCORE II risk factors.Conclusion: Cardiogenic and brain-derived causes is the main cause of postoperative death of patients,of which postoperative low cardiac output,malignant arrhythmia and postoperative stroke are common causes;postoperative infection and organ failure are the causes of low risk patients after cardiac surgery is the other main cause of death,of which lung infection and multiple organ failure are high incidence,and occasional accidents that lead to death after cardiac surgery also need attention and alertness.To further reduce postoperative mortality in cardiac surgery patients,reduce the occurrence of deaths,doctors need to understand various detailed causes of death and their corresponding risk factors and technical principles prevent it as early as possible,timely discovery is the key to reducing deaths,correct and effective diagnosis and treatment is the guarantee for reducing mortality.