Risk Factors Associated with Short-term Mortality and Complication Rates After Open Heart Surgery in a Regional Hospital Setting
Keywords:
Complication, Factor, Mortality, Open heart surgery, Regional hospitalAbstract
This study aimed to investigate the 30-day mortality rate, postoperative complications, and factors associated with short-term mortality among patients undergoing open heart surgery in a regional hospital in Thailand. A retrospective study was conducted using data from 106 patients who underwent open heart surgery at Trang Hospital, Thailand, between July 2022 and June 2024. The primary outcome was the 30-day mortality rate, while secondary outcomes included various postoperative complications and associated risk factors. Logistic regression analysis was employed to identify predictors of mortality. The results showed that six patients died within 30 days after surgery, representing a 30-day mortality rate of 5.7%. The rates of major complications were as follows: arrhythmias 21.7%, pulmonary or bloodstream infections 12.3%, kidney failure requiring dialysis 4.7%, stroke 2.8%, reoperation 2.8%, and deep sternal wound infection 0.9%. Preoperative factors significantly associated with 30-day mortality included older age and lower left ventricular ejection fraction, whereas postoperative predictors were stroke and kidney failure requiring dialysis. Moreover, patients with a predicted 30-day mortality rate greater than 8% according to the EuroSCORE II or GERAADA model had a substantially higher risk of death. In conclusion, the 30-day mortality rate after open heart surgery in this regional hospital remained relatively high compared with national reports. Advanced age, impaired cardiac function, and serious postoperative complications, particularly stroke and renal failure, were key determinants of early mortality. These findings underscore the importance of strengthening perioperative management, optimizing surgical risk assessment, and improving postoperative monitoring systems in regional hospital settings to reduce adverse outcomes.
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