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Long-term clinical outcomes and risk factors for the occurrence of post-operative complications after cardiovascular surgery in patients with Behçet's disease.

Authors
 Y. Ha  ;  S. Jung  ;  K. Lee  ;  S. Jung  ;  S. Lee  ;  M. Park  ;  S. Lee  ;  W. Shim  ;  B. Chang  ;  Y. Park 
Citation
 Clinical and Experimental Rheumatology, Vol.30(3 Suppl 72) : 18-26, 2012 
Journal Title
 Clinical and Experimental Rheumatology 
ISSN
 0392-856X 
Issue Date
2012
Abstract
OBJECTIVES: Cardiovascular surgery in patients with Behçet's disease (BD) frequently leads to postoperative complications such as anastomotic leakage, occlusion or pseudoaneurysm. We evaluated the clinical outcomes and related risk factors of postoperative complications in BD patients undergoing cardiovascular surgeries, as well as the long-term efficiency of postoperative immunosuppressive treatment. METHODS: Forty-one patients with BD who had undergone cardiovascular surgery between 1990 and 2009 were studied. We evaluated the patients' clinical data, postoperative complications, and survival rate. Risk factors related to the occurrence of postoperative complications were identified by univariate analysis using the Kaplan-Meier method with the log-rank test and multivariate analysis using the Cox proportional hazards regression model. RESULTS: Fifty-nine operations were performed in 41 patients. During the mean follow-up period of 65.3±48.1 months, complications such as paravalvular leakage, dehiscence, fistula, graft occlusion, or pseudoaneurysm occurred in 29 operations (49.2%). The cumulative occurrence rate of postoperative complication was 10.2% at three months, 32.8% at 12 months, and 43.8% at 24 months. Upon univariate analysis, young age, high Creactive protein levels, lack of postoperative immunosuppression, and short disease duration were identified as significant factors responsible for the occurrence of postoperative complications. In multivariate analysis, postoperative immunosuppression was found to independently lower the risk of complications. The 5-year survival rate was significantly higher in patients with postoperative immunosup immunosuppression than in those without (84.5% vs. 45.0%, p=0.011). CONCLUSIONS: The present study suggests that postoperative immunosuppressive therapy after cardiovascular surgeries in BD patients is important for reducing the development of serious postoperative complications.
Full Text
http://www.clinexprheumatol.org/abstract.asp?a=5363
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박민찬(Park, Min Chan) ORCID logo https://orcid.org/0000-0003-1189-7637
박용범(Park, Yong Beom)
심원흠(Shim, Won Heum)
이광훈(Lee, Kwang Hoon)
이상원(Lee, Sang Won) ORCID logo https://orcid.org/0000-0002-8038-3341
이수곤(Lee, Soo Kon)
장병철(Chang, Byung Chul)
정세진(Jung, Se Jin)
하유정(Ha, You Jung)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90001
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