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Hsieh W.C.,Institute Of Cardiovascular Diseases Prof Dr George Im Georgescu | Hsieh W.C.,Grigore T. Popa University of Medicine and Pharmacy | Chen P.C.,Institute Of Cardiovascular Diseases Prof Dr George Im Georgescu | Chen P.C.,Grigore T. Popa University of Medicine and Pharmacy | And 4 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015

Liver function is not considered as a risk factor by current risk scores, such as EUROSCORE II or STSScore for cardiac surgery. The aim of this study was to review the role of liver dysfunction, classified by the Child- Turcotte-Pugh classification or model for end-stage liver disease scores, as a risk factor for mortality and morbidity of patients following cardiac surgery. The Pubmed referencing library was searched. The rates of mortality and morbidity were calculated using SPSS software. The mortality rates in patients of Child class A, Child class B, and Child class C were pairwise compared respectively. A total of 22 reports including 939 patients from eight countries were reviewed. The mortality rate of patients increased in accordance with increased CTP classification. The lowest mortality rate was recorded in Child class A patients, followed by Child class B patients and the highest mortality rate was observed in Child class C patients. The mean complication rate ranged from 3.82% to 22.15%. Child class C patients should be considered unacceptable for cardiovascular surgery. As two studies revealed, patients with a higher MELD score had significantly higher mortality rates. Liver function should be viewed as an important risk factor for cardiovascular surgery, based on its strong association with mortality and morbidity. © 2015 E-Century Publishing Corporation. All rights reserved.


Dabija E.,Institute Of Cardiovascular Diseases Prof Dr George Im Georgescu | Dabija E.,Victor Babes University of Medicine and Pharmacy Timisoara | Dan M.,Institute Of Cardiovascular Diseases Prof Dr George Im Georgescu | Bosnea D.,Victor Babes University of Medicine and Pharmacy Timisoara | And 6 more authors.
Revista Romana de Medicina de Laborator | Year: 2011

Objectives: to analyze the aetiology, the origin, epidemiologic features and outcome of bloodstream infections in patients that underwent cardiovascular surgery. Methods: A retrospective study of bloodstream infections was conducted between 27th April 2001 - 26 June 2010 in the Cardiovascular Surgery Clinic of Iasi, Romania. Results: We detected 114 consecutive bloodstream infections in a number of 4304 hospitalizations. Bacteraemia was secondary to an infectious body site in 53.50% of the episodes. Cell-wall deficient forms (52.63%) were the most prevalent microorganisms (78 strains, out of which 53 reverted to the classical state and 25 were L - stable), followed by Gram-positive cocci, Gram-negative bacilli, Gram-positive bacilli, fungi, HACEK group and anaerobes. Conclusions: We found a high proportion of cell wall deficient forms, rarely reported before. This may be due to blood culture collection under antimicrobial therapy (p=0.016), especially β-lactams, and/or the use of more adequate blood culture methods (acridine orange stain for microscopy of the blood culture and reversion media). The therapy of the infections with cell wall deficient forms raises particular problems. For systemic infections associations of chloramphenicol + spiramycin, erythromycin + cephalotin, chloramphenicol + tetracyclin could be adequate treatment, but currently we are collecting more data in order to establish therapeutic protocols.


Hsieh W.C.,Institute Of Cardiovascular Diseases Prof Dr George Im Georgescu | Chen P.C.,Institute Of Cardiovascular Diseases Prof Dr George Im Georgescu | George G.,Institute Of Cardiovascular Diseases Prof Dr George Im Georgescu | Tinica G.,Institute Of Cardiovascular Diseases Prof Dr George Im Georgescu | Corciova F.-C.,Institute Of Cardiovascular Diseases Prof Dr George Im Georgescu
European Review for Medical and Pharmacological Sciences | Year: 2015

OBJECTIVE: Current cardiac risk assessments such as EuroSCORE II and the STS-Score do not take liver dysfunction into account. The purpose of this study was to evaluate the prevalence and post-operative morbidity risk factors following cardiac surgery of patients with chronic viral hepatitis. PATIENTS AND METHODS: The study group consisted of 105 patients with documented chronic viral hepatitis who were subject to elective cardiac surgery from 2001 to 2012. Subjects were evaluated for pre-operative liver dysfunction according to the MELD score. RESULTS: The average MELD score of the study group was 10.00 ± 6.00. The average EuroSCORE ii of the study group was 2.07% ± 1.62%. The primary post-operative complication was cardiac complications (n=57, 54.3%). Analysis showed significant differences in meld score, bilirubin and smoking. Multivariate logistic regression analysis showed that the variables entering into the model included such risk factors with a significant or near significant (p < 0.2) influence on hospital morbidity and consisted in valve vs. coronary artery disease, valve/cad, aortic valve replacement vs. Coronary artery bypass graft, and bilirubin (mg/dl). CONCLUSIONS: it is vital that liver dysfunction is added to the risk models which are currently utilized to predict the post-operative morbidity of cardiac surgery patients.

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