IJCS | Volume 31, Nº5, September / October 2018

482 Oliveira et al. Mortality and survival in aortic arch surgeries Int J Cardiovasc Sci. 2018;31(5)466-482 Original Article Pneumonia: ( ) yes ( ) no ( ) NI SARS: ( ) yes ( ) no ( ) NI Uni/bilateral pleural effusion: ( ) yes ( ) no ( ) NI Metabolic: Post-operative acute renal failure (ARF): ( ) yes ( ) no ( ) NI Dialysis: ( ) yes ( ) no ( ) NI If ARF o dialysis: Highest serum Cr _____________ Highest glycemia _____________ Insulin: ( ) yes ( ) no ( ) NI Hyperkalemia: ( ) yes ( ) no ( ) NI Neurologic: stroke ( ) Embolic ischemic ( ) Thrombotic ischemic ( ) Unspecified ischemic ( )Hemorrhagic ( ) Unspecified ( ) No ( ) NI Confirmation of stroke: CT: ( ) yes ( ) no ( ) NI MRI: ( ) yes ( ) no ( ) NI Without tests: ( ) yes ( ) no ( ) NI Coma: ( ) yes ( ) no ( ) NI Convulsive episode: ( ) yes ( ) no ( ) NI Psychiatric disorder (delirium): ( ) yes ( ) no ( ) NI Paraplegia: ( ) yes ( ) no ( ) NI Cardiologic HF: ( ) yes ( ) no ( ) NI PTE: ( ) yes ( ) no ( ) NI Arrhythmia: ( ) yes ( ) no ( ) NI Which one? _______________________________________________________________ Infection Superficial: ( ) yes ( ) no ( ) NI Soft tissues: ( ) yes ( ) no ( ) NI Mediastinum: ( ) yes ( ) no ( ) NI Sepsis: ( ) yes ( ) no ( ) NI Septic shock: ( ) yes ( ) no ( ) NI Amines: ( ) yes ( ) no ( ) NI Other sites: _____________________________________________________________ ( ) NI Peripheral vascular DVT: ( ) yes ( ) no ( ) NI Other complications: MSOF ( ) yes ( ) no ( ) NI Bleeding ( ) Yes, without transfusion ( ) Yes, with transfusion ( ) no ( ) NI ( ) Yes, without reoperation ( ) Yes, with reoperation ( ) no ( ) NI Drain output (first 24 hours) ____________________________ (mL) ( ) NI 6. In-hospital course Time of hospitalization __________ ( ) NI Number of days Time of ICU __________ ( ) NI Number of days Time of MV __________ ( ) NI Number of days Hospital course ( ) Death ( ) Discharge ( ) Transfer ( ) NI Date _____/_____/__________ Cause of death _______________________________________________________________________________ IDC _____________________________________ ( ) NI Place of death ( ) Ward/room Surgical ( ) Operating room ( ) ICU ( ) Semi-intensive care unit ( ) NI ( ) Survivor