Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral

Background: There is no consensus regarding which risk factors influence the outcome of mitral valve replacement. Aim: To study the effects ofthe referring health care system and other factors on the results of mitral replacement. Patients and Methods: We included 632 patients operated between 1990...

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Autores principales:	Morán,Sergio, Muñoz,Cecilia, Garayar,Bernardita, Zalaquett,Ricardo, Irarrázaval,Manuel J, Becker,Pedro, González,Rodrigo
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2013
Materias:	Delivery of health care Heart valve prosthesis implantation Mitral valve Risk factors
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000700005
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spelling	oai:scielo:S0034-988720130007000052013-12-17Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitralMorán,SergioMuñoz,CeciliaGarayar,BernarditaZalaquett,RicardoIrarrázaval,Manuel JBecker,PedroGonzález,Rodrigo Delivery of health care Heart valve prosthesis implantation Mitral valve Risk factors Background: There is no consensus regarding which risk factors influence the outcome of mitral valve replacement. Aim: To study the effects ofthe referring health care system and other factors on the results of mitral replacement. Patients and Methods: We included 632 patients operated between 1990 and 2010 receiving the St Jude prosthesis. Patients were divided into three groups, group 1 composed by 180 patients coming from the Public System, group 2 composed by 182 patients coming from the University System and group 3 composed by 270 patients coming from the Private System. Results: Overall operative mortality was 4.3%. There was no difference between groups in mortality. Factors responsible for operative mortality were: emergency operation (Odds Patio (OR): 5.6 P < 0.01) and left ventricular function (according to ejection fraction) grade III to IV (OR: 2.5 p = 0.048). Actuarial survival rates at 1, 5, 10, 15 and 20 years were 95%, 87%, 76%, 61% and 41%, respectively. Risk factors for long-term mortality were diabetes (OR: 3.3 p < 0.01), left ventricular function grades III-IV (OR: 2.6 p < 0.01), New York Heart Association functional class III to PV (OR: 2.1 p < 0.005) and male sex (OR: 1.5 p < 0.032). Conclusions: Referring health care system and type of surgery do not constitute a risk factor for mitral replacement. Risk factors were: emergency surgery, ventricular function grades III-IV, diabetes, functional capacity class III-IV and male sex. Integration of public and private health care systems in a university hospital setting achieves excellent outcomes for complex pathologyinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.141 n.7 20132013-07-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000700005es10.4067/S0034-98872013000700005
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Delivery of health care Heart valve prosthesis implantation Mitral valve Risk factors
spellingShingle	Delivery of health care Heart valve prosthesis implantation Mitral valve Risk factors Morán,Sergio Muñoz,Cecilia Garayar,Bernardita Zalaquett,Ricardo Irarrázaval,Manuel J Becker,Pedro González,Rodrigo Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral
description	Background: There is no consensus regarding which risk factors influence the outcome of mitral valve replacement. Aim: To study the effects ofthe referring health care system and other factors on the results of mitral replacement. Patients and Methods: We included 632 patients operated between 1990 and 2010 receiving the St Jude prosthesis. Patients were divided into three groups, group 1 composed by 180 patients coming from the Public System, group 2 composed by 182 patients coming from the University System and group 3 composed by 270 patients coming from the Private System. Results: Overall operative mortality was 4.3%. There was no difference between groups in mortality. Factors responsible for operative mortality were: emergency operation (Odds Patio (OR): 5.6 P < 0.01) and left ventricular function (according to ejection fraction) grade III to IV (OR: 2.5 p = 0.048). Actuarial survival rates at 1, 5, 10, 15 and 20 years were 95%, 87%, 76%, 61% and 41%, respectively. Risk factors for long-term mortality were diabetes (OR: 3.3 p < 0.01), left ventricular function grades III-IV (OR: 2.6 p < 0.01), New York Heart Association functional class III to PV (OR: 2.1 p < 0.005) and male sex (OR: 1.5 p < 0.032). Conclusions: Referring health care system and type of surgery do not constitute a risk factor for mitral replacement. Risk factors were: emergency surgery, ventricular function grades III-IV, diabetes, functional capacity class III-IV and male sex. Integration of public and private health care systems in a university hospital setting achieves excellent outcomes for complex pathology
author	Morán,Sergio Muñoz,Cecilia Garayar,Bernardita Zalaquett,Ricardo Irarrázaval,Manuel J Becker,Pedro González,Rodrigo
author_facet	Morán,Sergio Muñoz,Cecilia Garayar,Bernardita Zalaquett,Ricardo Irarrázaval,Manuel J Becker,Pedro González,Rodrigo
author_sort	Morán,Sergio
title	Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral
title_short	Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral
title_full	Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral
title_fullStr	Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral
title_full_unstemmed	Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral
title_sort	influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral
publisher	Sociedad Médica de Santiago
publishDate	2013
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000700005
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Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral

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