OBJECTIVE: To determine the incidence, diagnostic features, and perioperative predictors of acute @entity2679 after cardiovascular surgery. DESIGN: Inception cohort study. SETTING: A tertiary care 54-bed cardiothoracic ICU. @entity1 : All @entity1 admitted to an ICU after cardiovascular surgery during a 42-month period. INTERVENTION: Collection of relevant preoperative, operative, and ICU data from a database and medical charts. PRIMARY OUTCOME: Postoperative acute @entity2679 (AC). RESULTS: Out of 11,330 admissions, 876 @entity1 stayed in the ICU more than 7 days and 30 of them (3%) developed postoperative AC. AC was diagnosed a median of 26 days after cardiovascular surgery (interquartile range, 11 to 41 days). All @entity1 with AC developed at least two criteria of the @entity1850 ( @entity1850 ), and 16 of them (53%) were vasopressor-dependent on the day of diagnosis. Trends in biochemical testing of liver function were not diagnostic for AC. @entity204 occurred in seven of 17 @entity1 (41%) who underwent cholecystectomy, three of nine @entity1 (33%) treated with percutaneous cholecystostomy, and one of four @entity1 (25%) treated conservatively (p=not significant). Specific earlier predictors of AC were @entity455 , preoperative @entity26 delivery less than 430 mL/min x m2, longer times on cardiopulmonary bypass, surgical re-exploration, ICU course complicated by @entity943 , mechanical ventilation > or = 3 days, @entity2259 , and @entity580 . CONCLUSION: The incidence of AC is low after cardiovascular surgery. Although @entity1850 and @entity1344 were common at the time of diagnosis, the delayed occurrence and lack of specificity of these features for AC limited their utility for early diagnosis. Specific predictors of AC should be sought in the ICU setting to identify @entity1 who are at risk for AC after cardiovascular surgery. When identified, such predictors can prompt earlier diagnosis and treatment. Further evaluation of the selection criteria for different treatment options is needed in order to decrease the morbidity and mortality associated with AC.

Perioperative predictors of acute XXXX after cardiovascular surgery.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity1344 :: ('MESH:D043171', 'Disease') :: ['hemodynamic instability'] @entity455 :: ('MESH:D014652', 'Disease') :: ['arterial vascular disease'] @entity943 :: ('MESH:D001145', 'Disease') :: ['cardiac arrhythmia'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity2679 :: ('MESH:D002764', 'Disease') :: ['cholecystitis'] @entity1850 :: ('MESH:D018746', 'Disease') :: ['systemic inflammatory response syndrome', 'SIRS'] @entity580 :: ('MESH:D003428', 'Disease') :: ['nosocomial infections'] @entity204 :: ('MESH:D003643', 'Disease') :: ['Death'] @entity2259 :: ('MESH:D016470', 'Disease') :: ['bacteremia']
@entity2679 :: (MESH:D002764,Disease) :: ['cholecystitis']
