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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 4, July/August 2015
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AFRICA
that the mortality rate of the older patient group was higher
than that in the younger group. However, the logistic regression
analysis indicated that the only independent risk factor for
mortality was a prolonged cardiopulmonary bypass time.
In addition, subgroup analysis revealed different results. For
example, in the older patient group, chronic renal failure and
prolonged cardiopulmonary bypass were identified as factors
that affected mortality rate. In younger patients, female gender,
diabetes mellitus, emergency operations, higher EuroSCORE
values, prolonged cardiopulmonary bypass time, and prolonged
stay in the ICU were independent risk factors for mortality.
In elective operations, advanced patient age and prolonged
cardiopulmonary bypass time were identified as factors that
affected mortality rates.
Complications with the intra-aortic balloon pump were
describedinpreviousstudies:limbischaemia,thrombocytopaenia,
arterial rupture or dissection, and sepsis and local infections.
4-6,10,18
Complication rates have been reported from 26 to 50% in
different studies. The risk factors for IABP complications
were stated as increased age, female gender, duration of IABP
treatment, presence of diabetes mellitus, and having several
risk factors (e.g. obesity, smoking, hypertension, cardiogenic
shock, inotropic support, low cardiac output, increased systemic
vascular resistance, and ankle–brachial pressure index
<
0.8).
In our study, the IABP complication rate was higher in
older patients compared to younger patients (25 vs 12.2%).
Mild thrombocytopaenia was the most frequently detected
complication. When thrombocytopaenia is detected, IABP
therapy is terminated immediately so that fewer bleeding
complications occur.
Limitations
Our study was a single-institution, retrospective study, which had
a relatively small sample size. This subject may require further
multicentre, randomised trials. Unaccounted for confounders
may have been inherent in such a retrospective analysis.
Conclusion
Intra-aortic balloon pumps are important cardiac support
instruments that are easily implemented and have beneficial
effects for resolving transient ischaemic situations. Whether
young or old, patients who require IABP support have a high
risk of mortality. Moreover, the association of elderly patients
with increased incidences of co-morbid disease makes them even
more susceptible to mortality. We question whether IABP may
rather be used in the intra-operative period as a prophylactic
device in elderly patients with multiple risk factors.
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