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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 6, November/December 2016

AFRICA

341

aortic aneurysms died within five years of the diagnosis.

9

Aortic surgeries are complex and have high morbidity and

mortality rates. The risks of surgery include paraplegia, stroke,

bleeding and death; however rupture, dissection and death

may also occur when the aneurysm is left unoperated. If

no intervention is done at the time of cardiac surgery, the

aneurysm may develop and rupture, and will need a second

open-heart procedure, with additional technical challenges and

complications. An initial concomitant surgery may increase the

operative risks but protects patients from long-term aneurysmatic

complications.

Replacement of ascending aortic aneurysms often requires

significant additional surgery, such as CABG and AVR. Severe

aortic valve disease is occasionally associated with dilation of the

Table 6. Potential risk factors associated with mortality in the multivariate logistic regression equation

Variables

B

SE

Wald

Sig

Exp (B)

95% CI for exp (B)

Lower

Upper

STEP 1

a

(beginning model)

Constant

–5.23

1.587

10.844

0.001

0.005

Age (≥ 70 years)

1.146

0.732

2.452

0.117

3.144

0.750

13.190

Additional operations

AVR

0.945

1.246

0.575

0.448

2.573

0.224

29.606

CABG

0.540

1.272

0.180

0.671

1.716

0.142

20.752

AVR+CABG

1.013

1.434

0.499

0.480

2.755

0.166

45.761

Bentall

0.088

1.426

0.004

0.951

1.092

0.067

17.856

DM (yes)

0.573

0.767

0.559

0.455

1.774

0.395

7.971

Inotrope use (yes)

2.510

1.134

4.899

0.027

12.308

1.333

113.645

IABP (yes)

2.173

0.881

6.091

0.014

8.789

1.564

49.379

STEP 4 (final model)

Constant

–3.87

1.028

14.154

<

0.001

0.021

Inotrope use (yes)

2.280

1.078

4.471

0.034

9.779

1.181

80.947

IABP (yes)

2.200

0.770

8.177

0.004

9.029

1.998

40.797

a

Variable(s) entered on step 1: age, additional operations, DM, inotrope use, ABP.

AVR: aortic valve replacement, CABG: coronary arterial bypass grefting COPD: chronic obstructive pulmonary disease, DM: diabetes mellitus, PAD: peripheral arte-

rial disease, IABP: intra-aortic balloon pump.

Table 5. Potential risk factors associated with mortality in the univariate logistic regression equation

Variable

No

Total no

Prevalence

(%)

B

SE

Wald

Sig

Exp (B)

95% CI for exp (B)

Lower

Upper

Constant

–1.72

0.280

37.774

<

0.001

0.179

Age (years)

<

70

8

69

11.6

≥ 70

7

30

23.3

0.842

0.572

2.162

0.141

2.321

0.756

7.127

Gender

Female

5

39

12.8

Male

10

60

16.7

0.307

0.591

0.271

0.603

1.360

0.427

4.332

Additional operations

No

1

19

5.3

4.815

0.307

AVR

4

36

11.1

0.811

1.156

0.492

0.483

2.250

0.233

21.694

CABG

5

25

20.0

1.504

1.143

1.733

0.188

4.500

0.479

42.248

AVR+CABG

3

8

37.5

2.380

1.261

3.564

0.059

10.800

0.913

127.754

Bentall

2

11

18.2

1.386

1.291

1.153

0.283

4.000

0.319

50.229

COPD

No

13

89

14.6

Yes

2

10

20.0

0.379

0.846

0.201

0.654

1.462

0.279

7.667

PAD

No

14

94

14.9

Yes

1

5

20.0

0.357

1.155

0.095

0.757

1.429

0.149

13.741

DM

No

9

74

12.2

Yes

6

25

24.0

0.824

0.588

1.966

0.161

2.281

0.720

7.221

Inotrope use

No

1

42

2.4

Yes

14

57

24.6

2.591

1.058

6.001

0.014

13.349

1.679

106.145

IABP

No

9

89

10.1

Yes

6

10

60.0

2.590

0.735

12.419

<

0.001

13.333

3.157

56.312

AVR: aortic valve replacement, CABG: coronary arterial bypass grafting, COPD: chronic obstructive pulmonary disease, DM: diabetes mellitus, PAD: peripheral arte-

rial disease, IABP: intra-aortic balloon pump.