biostudies-literatureUnknown7(5)Jiang L<h4>Objectives</h4>To investigate the role of pulmonary artery pressure (PAP) in predicting in-hospital death after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease.<h4>Design</h4>An observational study.<h4>Setting</h4>Guangdong General Hospital, China.<h4>Participants</h4>1639middle-aged and aged patients (mean age 57±6 years) diagnosed with rheumatic mitral disease, undergoing valve replacement surgery and receiving coronary angiography and transthoracic echocardiography before operation, were enrolled.<h4>Interventions</h4>All participants underwent valve replacement surgery and received coronary angiography before operation.<h4>Primary and secondary outcome measures</h4>In-hospital death and 1-year mortality after operation.<h4>Methods</h4>Included patients were divided into four groups based on the preoperative PAP obtained by echocardiography: group A (PAP?30?mm Hg); group B (>30 mm Hg<PAP?50?mm Hg), group C (>50 mm Hg<PAP?70?mm Hg) and group D (PAP>70?mm Hg). The relationship between PAP and in-hospital death and cumulative rate of 1-year mortality was evaluated.<h4>Results</h4>In-hospital mortality rate increased gradually but significantly as the PAP level increased, with 1.9% in group A (n=268), 2.3% in group B (n=771), 4.7% in group C (n=384) and 10.2% in group D (n=216) (p<0.001). Multivariate analysis showed that PAP>70?mm Hg was an independent predictor of in-hospital death (OR=2.93, 95%?CI 1.61 to 5.32, p<0.001). PAP>52.5?mm Hg had a sensitivity of 60.3% and specificity of 67.7% in predicting in-hospital death (area under the curve=0.672, 95%?CI 0.602 to 0.743, p<0.001). Kaplan-Meier analysis showed that patients with PAP>52.5?mm Hg had higher 1-year mortality after operation than those without (log-rank=21.51, p<0.001).<h4>Conclusions</h4>PAP could serve as a predictor of postoperative in-hospital and 1-year mortality after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease.BMJ opene014316https://www.ebi.ac.uk/biostudies/studies/S-EPMC5777461biostudies-literatureValue of pulmonary artery pressure in predicting in-hospital and one-year mortality after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease: an observational study.PMC5777461Liu JTan NJiang LHe PCWei XBFeng DLiu YHChen JYYu DQfalseValue of pulmonary artery pressure in predicting in-hospital and one-year mortality after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease: an observational study.<h4>Objectives</h4>To investigate the role of pulmonary artery pressure (PAP) in predicting in-hospital death after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease.<h4>Design</h4>An observational study.<h4>Setting</h4>Guangdong General Hospital, China.<h4>Participants</h4>1639middle-aged and aged patients (mean age 57±6 years) diagnosed with rheumatic mitral disease, undergoing valve replacement surgery and receiving coronary angiography and transthoracic echocardiography before operation, were enrolled.<h4>Interventions</h4>All participants underwent valve replacement surgery and received coronary angiography before operation.<h4>Primary and secondary outcome measures</h4>In-hospital death and 1-year mortality after operation.<h4>Methods</h4>Included patients were divided into four groups based on the preoperative PAP obtained by echocardiography: group A (PAP?30?mm Hg); group B (>30 mm Hg<PAP?50?mm Hg), group C (>50 mm Hg<PAP?70?mm Hg) and group D (PAP>70?mm Hg). The relationship between PAP and in-hospital death and cumulative rate of 1-year mortality was evaluated.<h4>Results</h4>In-hospital mortality rate increased gradually but significantly as the PAP level increased, with 1.9% in group A (n=268), 2.3% in group B (n=771), 4.7% in group C (n=384) and 10.2% in group D (n=216) (p<0.001). Multivariate analysis showed that PAP>70?mm Hg was an independent predictor of in-hospital death (OR=2.93, 95%?CI 1.61 to 5.32, p<0.001). PAP>52.5?mm Hg had a sensitivity of 60.3% and specificity of 67.7% in predicting in-hospital death (area under the curve=0.672, 95%?CI 0.602 to 0.743, p<0.001). Kaplan-Meier analysis showed that patients with PAP>52.5?mm Hg had higher 1-year mortality after operation than those without (log-rank=21.51, p<0.001).<h4>Conclusions</h4>PAP could serve as a predictor of postoperative in-hospital and 1-year mortality after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease.2017-01-01T00:00:00Z2017 May2021-02-21T07:27:07Z2019-03-26T22:46:40ZS-EPMC57774612849581210.1136/bmjopen-2016-014316