Surgery for valvular heart disease: a population-based study in a brazilian urban center

Detalhes bibliográficos
Autor(a) principal: Ribeiro, Guilherme S.
Data de Publicação: 2012
Outros Autores: Tartof, Sara Yee, Oliveira, Dalton W. S., Guedes, Aldalice C. S., Reis, Mitermayer G., Riley, Lee W., Ko, Albert I.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFBA
Texto Completo: http://www.repositorio.ufba.br/ri/handle/ri/6080
Resumo: Background:In middle income countries, the burden of rheumatic heart disease (RHD) remains high, but the prevalence of other heart valve diseases may rise as the population life expectancy increases. Here, we compared population-based data on surgical procedures to assess the relative importance of causes of heart valve disease in Salvador, Brazil. Methodology/Principal Findings: Medical charts of patients who underwent surgery for valvular heart disease from January 2002–December 2005 were reviewed. Incidence of surgery for valvular heart disease was calculated. Logistic regression was used to identify factors associated with in-hospital death following surgery. The most common etiologies for valvular dysfunction in 491 valvular heart surgery patients were RHD (60.3%), degenerative valve disease (15.3%), and endocarditis (4.5%). Mean annual incidence for surgeries due to any valvular heart diseases, RHD, and degenerative valvular disease were 5.02, 3.03, and 0.77 per 100,000 population, respectively. Incidence of surgery due to RHD was highest in young adults; procedures were predominantly paid by the public health sector. In contrast, the incidence of surgery due to degenerative valvular disease was highest among those older than 60 years of age; procedures were mostly paid by the private sector. The overall in-hospital case-fatality ratio was 11.9%. Independent factors associated with death included increase in age (odds ratio: 1.04 per year of age; 95% confidence interval: 1.02–1.06), endocarditis (6.35; 1.92–21.04), multiple valve operative procedures (4.35; 2.12–8.95), and prior heart valve surgery (2.49; 1.05–5.87). Conclusions/Significance:RHD remains the main cause for valvular heart surgery in Salvador, which primarily affects young adults without private health insurance. In contrast, surgery due to degenerative valvular disease primarily impacts the elderly with private health insurance. Strategies to reduce the burden of valvular heart disease will need to address the disparate factors that contribute to RHD as well as degenerative valve disease.
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spelling Ribeiro, Guilherme S.Tartof, Sara YeeOliveira, Dalton W. S.Guedes, Aldalice C. S.Reis, Mitermayer G.Riley, Lee W.Ko, Albert I.Ribeiro, Guilherme S.Tartof, Sara YeeOliveira, Dalton W. S.Guedes, Aldalice C. S.Reis, Mitermayer G.Riley, Lee W.Ko, Albert I.2012-06-06T12:57:14Z2012-06-06T12:57:14Z20121932-6203http://www.repositorio.ufba.br/ri/handle/ri/6080v.7, n.5, p.37855Background:In middle income countries, the burden of rheumatic heart disease (RHD) remains high, but the prevalence of other heart valve diseases may rise as the population life expectancy increases. Here, we compared population-based data on surgical procedures to assess the relative importance of causes of heart valve disease in Salvador, Brazil. Methodology/Principal Findings: Medical charts of patients who underwent surgery for valvular heart disease from January 2002–December 2005 were reviewed. Incidence of surgery for valvular heart disease was calculated. Logistic regression was used to identify factors associated with in-hospital death following surgery. The most common etiologies for valvular dysfunction in 491 valvular heart surgery patients were RHD (60.3%), degenerative valve disease (15.3%), and endocarditis (4.5%). Mean annual incidence for surgeries due to any valvular heart diseases, RHD, and degenerative valvular disease were 5.02, 3.03, and 0.77 per 100,000 population, respectively. Incidence of surgery due to RHD was highest in young adults; procedures were predominantly paid by the public health sector. In contrast, the incidence of surgery due to degenerative valvular disease was highest among those older than 60 years of age; procedures were mostly paid by the private sector. The overall in-hospital case-fatality ratio was 11.9%. Independent factors associated with death included increase in age (odds ratio: 1.04 per year of age; 95% confidence interval: 1.02–1.06), endocarditis (6.35; 1.92–21.04), multiple valve operative procedures (4.35; 2.12–8.95), and prior heart valve surgery (2.49; 1.05–5.87). Conclusions/Significance:RHD remains the main cause for valvular heart surgery in Salvador, which primarily affects young adults without private health insurance. In contrast, surgery due to degenerative valvular disease primarily impacts the elderly with private health insurance. Strategies to reduce the burden of valvular heart disease will need to address the disparate factors that contribute to RHD as well as degenerative valve disease.Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2012-06-06T12:57:14Z No. of bitstreams: 1 Ribeiro GS. Surgery for valvular 2012.pdf: 182152 bytes, checksum: 1fa72c4b53fc8934eaf7535120432be3 (MD5)Made available in DSpace on 2012-06-06T12:57:14Z (GMT). No. of bitstreams: 1 Ribeiro GS. Surgery for valvular 2012.pdf: 182152 bytes, checksum: 1fa72c4b53fc8934eaf7535120432be3 (MD5) Previous issue date: 2012San FranciscoVálvula CardíacaCirurgia CardíacaSurgery for valvular heart disease: a population-based study in a brazilian urban centerPLos ONEinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleengreponame:Repositório Institucional da UFBAinstname:Universidade Federal da Bahia (UFBA)instacron:UFBAinfo:eu-repo/semantics/openAccessORIGINALRibeiro GS. Surgery for valvular 2012.pdfRibeiro GS. Surgery for valvular 2012.pdfapplication/pdf182152https://repositorio.ufba.br/bitstream/ri/6080/1/Ribeiro%20GS.%20Surgery%20for%20valvular%202012.pdf1fa72c4b53fc8934eaf7535120432be3MD51LICENSElicense.txtlicense.txttext/plain1762https://repositorio.ufba.br/bitstream/ri/6080/2/license.txt1b89a9a0548218172d7c829f87a0eab9MD52TEXTRibeiro GS. Surgery for valvular 2012.pdf.txtRibeiro GS. 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dc.title.pt_BR.fl_str_mv Surgery for valvular heart disease: a population-based study in a brazilian urban center
dc.title.alternative.pt_BR.fl_str_mv PLos ONE
title Surgery for valvular heart disease: a population-based study in a brazilian urban center
spellingShingle Surgery for valvular heart disease: a population-based study in a brazilian urban center
Ribeiro, Guilherme S.
Válvula Cardíaca
Cirurgia Cardíaca
title_short Surgery for valvular heart disease: a population-based study in a brazilian urban center
title_full Surgery for valvular heart disease: a population-based study in a brazilian urban center
title_fullStr Surgery for valvular heart disease: a population-based study in a brazilian urban center
title_full_unstemmed Surgery for valvular heart disease: a population-based study in a brazilian urban center
title_sort Surgery for valvular heart disease: a population-based study in a brazilian urban center
author Ribeiro, Guilherme S.
author_facet Ribeiro, Guilherme S.
Tartof, Sara Yee
Oliveira, Dalton W. S.
Guedes, Aldalice C. S.
Reis, Mitermayer G.
Riley, Lee W.
Ko, Albert I.
author_role author
author2 Tartof, Sara Yee
Oliveira, Dalton W. S.
Guedes, Aldalice C. S.
Reis, Mitermayer G.
Riley, Lee W.
Ko, Albert I.
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Ribeiro, Guilherme S.
Tartof, Sara Yee
Oliveira, Dalton W. S.
Guedes, Aldalice C. S.
Reis, Mitermayer G.
Riley, Lee W.
Ko, Albert I.
Ribeiro, Guilherme S.
Tartof, Sara Yee
Oliveira, Dalton W. S.
Guedes, Aldalice C. S.
Reis, Mitermayer G.
Riley, Lee W.
Ko, Albert I.
dc.subject.por.fl_str_mv Válvula Cardíaca
Cirurgia Cardíaca
topic Válvula Cardíaca
Cirurgia Cardíaca
description Background:In middle income countries, the burden of rheumatic heart disease (RHD) remains high, but the prevalence of other heart valve diseases may rise as the population life expectancy increases. Here, we compared population-based data on surgical procedures to assess the relative importance of causes of heart valve disease in Salvador, Brazil. Methodology/Principal Findings: Medical charts of patients who underwent surgery for valvular heart disease from January 2002–December 2005 were reviewed. Incidence of surgery for valvular heart disease was calculated. Logistic regression was used to identify factors associated with in-hospital death following surgery. The most common etiologies for valvular dysfunction in 491 valvular heart surgery patients were RHD (60.3%), degenerative valve disease (15.3%), and endocarditis (4.5%). Mean annual incidence for surgeries due to any valvular heart diseases, RHD, and degenerative valvular disease were 5.02, 3.03, and 0.77 per 100,000 population, respectively. Incidence of surgery due to RHD was highest in young adults; procedures were predominantly paid by the public health sector. In contrast, the incidence of surgery due to degenerative valvular disease was highest among those older than 60 years of age; procedures were mostly paid by the private sector. The overall in-hospital case-fatality ratio was 11.9%. Independent factors associated with death included increase in age (odds ratio: 1.04 per year of age; 95% confidence interval: 1.02–1.06), endocarditis (6.35; 1.92–21.04), multiple valve operative procedures (4.35; 2.12–8.95), and prior heart valve surgery (2.49; 1.05–5.87). Conclusions/Significance:RHD remains the main cause for valvular heart surgery in Salvador, which primarily affects young adults without private health insurance. In contrast, surgery due to degenerative valvular disease primarily impacts the elderly with private health insurance. Strategies to reduce the burden of valvular heart disease will need to address the disparate factors that contribute to RHD as well as degenerative valve disease.
publishDate 2012
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