IJCS | Volume 32, Nº2, May/June 2019

DOI: 10.5935/2359-4802.20180095 217 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(3)217-226 Mailing Address: Patrick Hernani Matias Lobato Rua dos Pariquis, 3045, apt.: 303. Postal Code: 66040-045, Cremação, Belém, PA - Brazil. E-mail: pk_lobato@hotmail.com , lydia_lobato2015@hotmail.com Clinical Course of Patients Undergoing Myocardial Revascularization Surgery in a Public Cardiology Referral Hospital in Pará, Brazil Patrick Hernani Matias Lobat o, Feliciano Mendes Vieira Junio r, M ário Barbosa Guedes Nune s, Valleria Adriana Queiroz Lima Galuci o, E rcielem da Lima Barret o Fundação Pública Hospital de Clínicas Gaspar Vianna, PA - Brazil Manuscript received on January 12, 2018; reviewed on April 27,2018; accepted on June 26,2018. Abstract Background: Myocardial revascularization surgery (MRS) is the most frequently performed cardiac surgery in Brazil. However, data on mortality rates among patients undergoing MRS in hospitals other than the main referral centers in the northern Brazil are scarce. Objective: To describe the clinical course of patients that submitted to MRS in the major public cardiology referral hospital in the Brazilian Amazon. Methods: Retrospective cohort analysis, by review of medical records of patients who had undergone MRS at Hospital das Clínicas Gaspar Vianna (FHCGV) from January 2013 to June 2014. Results: A total of 179 patients were evaluated. Mortality rate was 11.7% until 30 days after surgery. Waiting time for surgery ≥ 30 days (OR 2.59, 95%CI 1.02 – 6.56, p = 0.039), infection during hospitalization (OR 3.28, 95%CI 1.15 – 9.39, p = 0.021) and need for hemodialysis after surgery (OR 9.06 95%CI 2.07 – 39.54, p = 0.001) were predictors of mortality after CABG. Conclusion: A high mortality rate in the study population was found, higher than that reported in the literature and in other regions of Brazil. (Int J Cardiovasc Sci. 2019;32(3)217-226) Keywords: MyocardialRevascularization/mortality;Hospitals,Public;Epidemiology;PostoperativeComplications. Introduction Ischemic heart disease is the main cause of death and work disability, causing high costs in public health and socio-economic impact in Western countries. 1 In Brazil, coronary artery disease (CAD) accounted for approximately 250 thousand hospitalizations and 16 thousand deaths in 2015. In the city of Belem, CAD caused nearly 800 hospitalizations and 151 deaths. 2 Management of ischemic heart disease is complex and encompasses the control of risk factors and symptoms, aiming at reducing morbidity and mortality and optimizing patients’ quality of life bymeans of optimized clinical therapy associated or not with revascularization procedures – percutaneous coronary intervention (PCI) or myocardial revascularization surgery (MRS). 3-6 Despite historical advances in clinical therapy and percutaneous intervention in terms of technique and materials, results of multicenter studies have shown that MRS is superior to both PCI and clinical treatment alone in reduction of major cardiovascular events in specific groups of patients, such as diabetics, patients with multiple vessel disease or complex CAD involving left coronary trunk. 5,7-10 MRS is the most performed cardiac surgery in Brazil, approximately 80% of them in public health centers. Mean mortality rate i is 6.2% in the country, 11 with wide variation by region (1.9% - 11.2%), 12 and higher in small surgical volume hospitals, public hospitals, and among female and older patients. 11 In a recent national registry, a total of 1,722 patients who had undergone cardiac surgery were prospectively