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Master Thesis

Impact du cancer sur la mortalité à court terme après chirurgie cardiaque

Abstract : Objective: the aim of this study was to analyze the association between a history of cancer and 90-day mortality following cardiac surgery with cardiopulmonary bypass. Material and methods: an observational monocentric study with data collected from a prospective institutional database was conducted. History of cancer was preoperatively identified, and relevant information was retrospectively collected from medical records. Ninety-day survival of patients with and without cancer was compared using a univariate Cox model and then adjusted using a multivariable Cox model. Results: between 2005 and 2017,12143 patients underwent cardiac surgery with CPB including 4681 (39%) isolated coronary artery bypass surgery. Median EuroSCORE II was 3.1 [IQR:1.5-6.4]. Nine hundred thirty patients (7.7%) had a diagnosis of cancer out of which 469 (50%) were diagnosed = 5 years before the index surgery; 103 (11%) patients had hemopathy and 825 (89%) solid cancers. The 90-day mortality was significantly higher among patients with cancer: 94/930 (10%) vs 814/11203 (7%) (HR = 1.34 [1.08-1.66], p<0.01). After adjustment, a diagnosis of cancer was not associated with 90-day mortality (aHR = 1.12 [0.90-1.39] p=0.33). Conclusions: after cardiac surgery with CPB, patients with a history of cancer had a higher unadjusted 90-day mortality rate but after adjustment there was no longer association between cancer and 90-day mortality. Based on our results a history of cancer should not be a contraindication for cardiac surgery with CPB. The effect of cancer on long-term mortality after cardiac surgery requires further research.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03185099
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Submitted on : Tuesday, March 30, 2021 - 10:40:15 AM
Last modification on : Friday, September 3, 2021 - 3:32:56 AM

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  • HAL Id : dumas-03185099, version 1

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Hadrien Portefaix. Impact du cancer sur la mortalité à court terme après chirurgie cardiaque. Médecine humaine et pathologie. 2019. ⟨dumas-03185099⟩

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