Features and markers of mortality of hospital patients that use intra-aortic balloon pump

Background

Intra-Aortic Balloon Pump (IABP) use has been proposed in cardiogenic shock, but cannot improve mortality alone. Preoperative criteria use of IABP can improve outcome and cost in heart surgical patients.

Objective

Description and analysis of demographic, clinical, surgical features of surviving and nonsurviving IABP patients.

Development and method

An observational and retrospective study was conducted between April 1998 and December 2000. Thirty-nine of 56 IABP users could be analyzed in two groups (group A comprised survivors and group B nonsurvivors), comparing gender, age, ventricular function, hemodynamic compromise state, surgical or percutaneous treatment, moment of IABP installation (pre- or postintervention). Statistical technique was Student's t test and Χ² test.

Results

There were 15 patients in group A and 24 in group B. There were no statistical differences between following variables: age, gender and ventricular function. There were statistical differences between the following variables: shock - group A 53.3%, Group B 87% (P = 0.017); and surgical treatment - group A 80%, group B 41.6% (P = 0.019). In the surgical subgroup we found preoperative IABP implantation in 83.3% of group A patients and 30% of group B patients (P = 0.016). Analyzing group B, we found four out of 14 patients in percutaneous subgroup treatment with favorable coronary anatomy for heart surgery that was not performed by clinical decision; four out of 10 in surgical subgroup treatment had Duke University Criteria of preoperative IABP implantation that was not performed by surgical staff decision.

Discussion

This small retrospective study suggests the importance of preoperative IABP implantation in high-risk patient and one advantage for IABP impact in mortality for surgical strategy.