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Analysis of in-hospital complications related to cardiac catheterization

BACKGROUND: The major limitations of cardiac catheterization are the occurrence of complications related to its invasive nature. Complications can vary from mild and transitory reactions to severe adverse events like myocardial infarction or death. OBJECTIVE: To assess the incidence, type and severity of complications related to cardiac catheterization in adults using a comprehensive system previously described. METHODS: We conducted a prospective cohort study in a tertiary reference center, and patient characteristics and in-hospital outcomes were registered in a dedicated database. Complications were categorized in nine types: allergic, ischemic, vascular, arrythmic, vagal, pyrogenic, neurological, embolic and congestive, and stratified in mild, moderate (resolved in 24 hours) or severe (needed hospitalization or another intervention). The predictive factors of complications were assessed by multivariate analysis. RESULTS: We included 1916 individuals, 59% male and with a mean age of 58±11 years. Complications occurred in 175 patients (190 events), and 63% were mild, 24% moderate e 13% severe. There was one (0.05%) death in the entire cohort. Vascular complications were the most common type (36%), followed by vagal (18%), ischemic (15%) and allergic (14%). Risk factors for complications by multivariate analysis were anticoagulant use (OR=3.59; CI=1.67-7.74; p=0.006) and prolonged examination time (OR=1.03; CI=1.02-1.04; p<0.001). CONCLUSIONS: In-hospital complications after cardiac catheterization are generally mild, and the events more commonly presented were vascular, vagal or ischemic. Anticoagulant use and prolonged examination time were independent predictors of complications.

Heart catheterization, adverse effects; Angiography, adverse effects; Coronary angiography, adverse effects


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