Cardiac Surgery in Chile: Pre-operative risk characterization and analytical outcomes

Background: Cardiovascular diseases are the leading cause of mortality worldwide, including in Chile, accounting for about 23% of all deaths. Advanced cardiac surgical procedures like coronary artery bypass grafting (CABG) and valve surgeries are vital for treating complex conditions. However, Chile lacks a national registry for cardiac surgeries, hindering systematic analysis of outcomes and pre-operative risk factors. Objectives: To characterize the preoperative risk factors associated with heart surgery in Chile. Methods: This study used an electronic database from Hospital Guillermo Grant Benavente in Concepción, Chile. From 2014 to 2023, 3,415 patients were included, analyzing preoperative demographics, clinical characteristics, comorbidities, and cardiovascular history. The Euroscore II model assessed risk, revealing discrepancies between predicted and observed mortality evaluated. Results: The cohort's mean age was 62.1 ± 11.7 years, with 67.7% male participants. Most interventions were CABG at 50.7% and valvuloplasty at 35.4%. Hypertension was the leading comorbidity at 77.1%, followed by diabetes at 36.1% and renal dysfunction at 10.1%. Functional capacity, assessed through NYHA classification, strongly correlated with risk; those in NYHA classes III and IV had significantly higher mortality rates. Observed mortality rates surpassed predictions in high-risk groups, especially for those needing preoperative support or undergoing emergency procedures. Conclusions: This study highlights the importance of preoperative risk assessment in cardiac surgery. It advocates for tailored models like recalibrating Euroscore II for the Chilean population and suggests establishing a national cardiac surgery registry. Systematic data collection is vital for improving surgical outcomes and supporting evidence-based care.