This study aimed to assess risk factors that predict the length of stay and 30-day mortality in subjects undergoing CAGB to evaluate the impact of IABP support in patients with low ejection fraction. The prospective study was conducted in the Cardiology Department of Punjab Institute of Cardiology Lahore from January 2022 to January 2023. A total of 315 patients were included in the study. The sample was divided into a study group (n=110, having LVEF ≤ 30%) and a control group (n=205, having EF > 30%). Pre-operative and intraoperative data of the patients were recorded. Post-operative complications were recorded, including LOS in the hospital and 30-day mortality. Patients in the study group required more emergency CABG ( P = .005), and IABP was also used more frequently in patients having EF< 30% (P<.001). LOS in hospital (P<.001) and ICU (P<.001) and 30-day mortality (P=.009) were higher in the study group. According to multivariate logistic regression analysis, in the study group history of cerebrovascular disease ( P = .018), peripheral vascular disease ( P = .004), congestive heart failure ( P = .027), and IABP use ( P = .002) were associated with the rate of 30-day mortality. Moreover, the increased length of hospital stay in these patients was associated with an increase in age (P<.001), hypertension (P=.040), and IABP use (P=.009). Based on the results, it can be concluded that the low ejection fraction positively affects increased LOS and 30-day mortality in subjects undergoing CABG; IABP insertion is a significant predictor of increased LOS and 30-day mortality and increases post-operative complications.
This study aimed to assess the effect of pulmonary hypertension on the outcomes of mitral valve surgery in terms of operative mortality, dependence on inotropic agents, duration of ventilation, length of ICU, and hospital stay. This comparative study was conducted at the Department of Cardiac Surgery, Faisalabad Institute of Cardiology, from January 2018 to July 2018. A total of 138 cases (69 in each group) were included in the study. Patients with mild or moderate PHT were enrolled in group A, and patients with severe PHT were in group B. Required surgery was performed. Outcomes, including operative mortality, duration of mechanical ventilation postoperatively, dependence on inotropic agents in ICU, and length of stay in ICU as well as hospital, were noted in both groups during intensive care stay. Difference between the two groups in terms of mean duration of mechanical ventilation (10.58±2.79 vs. 10.96±3.42 hours; p-value=0.480), mean duration of inotropic support (8.55±2.75 vs. 9.45±3.92 hours, p-value=0.122), mean length of ICU stay (2.97±1.34 vs. 3.32±1.40 days, p-value=0.138) and mean length of hospital stay (12.3±3.8 vs. 12.6±4.1 days, p-value=0.684) was not statistically significant. In patients with severe pulmonary hypertension, mitral valve replacement was found equally safe compared to those with mild to moderate pulmonary hypertension.
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