Ten-year institutional experience with palliative surgery for XXXX . Risk factors related to stage I mortality.

@entity1 @entity1699 @entity4794 @entity1146 @entity472 @entity204
BACKGROUND: We reviewed 212 consecutive @entity1 who underwent stage I palliative surgery for @entity1699 ( @entity1699 ) at our institution between January 1983 and June 1993. METHODS AND RESULTS: Six surgeons participated in the care of these @entity1 . Follow-up is 97% complete. Preoperative anatomic and physiological factors and procedural features of the stage I operation were analyzed for impact on stage I mortality, survival to stage II palliation, and actuarial survival. Hospital mortality was not significantly lower during the second half of the study period (P = .242). Operative mortality was 46.2%. Multivariate analysis revealed improved stage I operative survival in @entity1 with @entity4794 ( @entity4794 ) and @entity472 ( @entity472 ; P = .006). Additional risk factors for stage I mortality were a lower immediately pre-stage I pH (P = .034) and weight < 3 kg (P = .015). Overall first-year actuarial survival for @entity4794 / @entity472 was 59%, and it was 33% for all others (P = .001). Among stage I survivors, @entity1 with @entity4794 / @entity472 were more likely to survive to stage II palliation (P = .031). Analysis of actuarial survival of stage I survivors showed that a smaller ascending aorta (P < .001), aortic @entity1146 (P < .001), and mitral @entity1146 (P = .002) were all risk factors for intermediate @entity204 . CONCLUSIONS: Preoperative anatomic and physiological state are predictors of stage I mortality. @entity1699 anatomic subtype also influences intermediate outcome, most notably pre-stage II attrition. These data may be useful in choosing initial management for @entity1 with @entity1699 .
