Patients who have had heart surgery have a slight increased risk of death at 30 days, according to a study. Its author could not determine any medical reason for this peak in mortality.
30-day survival after heart surgery is a benchmark for most physicians… not always for the best. In the newspaper Health Services Research, a Johns Hopkins Medicine researcher highlights a peak in mortality at the 31e day on which no medical explanation can be provided.
Dr Bryan Maxwell, who conducted the study, used a national database containing the medical records of 595,000 patients admitted for heart surgery. Most have had bypass or valve surgery. About 19,500 patients died as a result of the operation. Two peaks emerge: at 6 days and at 30 days. The first was already known and can be explained by the close gap between usual recovery and the emergence of postoperative complications.
35% increased risk
The 30-day peak in mortality is difficult to explain. Dr. Maxwell advances several hypotheses. He believes that by this time healthy patients have already been able to leave the hospital. Those that remain are then complicated or very sick cases. But “we have no valid medical explanation,” he admits. On the other hand, the researcher expresses his fears about a change in the behavior of doctors. After 30 days, it is possible that the treatment is relaxed as soon as the operation is considered a success.
Yet, Dr. Bryan Maxwell points out, this 30-day deadline is purely arbitrary. It does not say anything about the patient’s chances of survival. This benchmark could even bring too much hope to patients and patients’ families, and unnecessarily prolong the hospital stay, depending on the case. The harmful effect of this symbolic date is in any case undeniable: the risk of dying on the 31e following heart surgery is 1%. The previous week, this risk did not exceed 0.81% … which represents an increase of 35%. This is especially the strongest variation over a period of 60 days.
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