A 50-year-old female, diabetic patient with chest pain and dizziness

Ranjan, Redoy; Joshi, Dharmendra; Ullah, Mohammad Ata; Bajracharya, Prashant; Saha, Sanjoy Kumar; Adhikary, Asit Baran

doi:10.3329/bsmmuj.v12i4.44274

“…Male occupied 88% of the total study population which reflects the male predominance for CAD [ 12 ]. Many studies have shown the significant impact of age, female gender, smoking, peripheral vascular disease, hypertension, diabetes mellitus, ischemic heart disease/myocardial infarction, and other risk factors on in-hospital mortality of patients [ 7 , 13 ] but these were well controlled before the operation in this study. Hence, the results were not statistically significant in this study.…”

Section: Discussionmentioning

confidence: 70%

Role of pre-operative red cell distribution width estimation in the prediction of in-hospital mortality after off-pump coronary artery bypass grafting

Joshi

¹

,

Chowdhury

²

,

Alauddin

³

et al. 2021

J Cardiothorac Surg

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Background Red cell distribution width (RDW) level is routinely provided in a simple and inexpensive complete blood count report. However, RDW is sometimes overlooked. Recently a higher RDW level is found associated with postoperative mortality after off-pump coronary artery bypass. Many risk-prediction tools are available, like the European System for Cardiac Operative Risk Evaluation, Society of Thoracic Surgeons score, etc. but all need improvement for better prediction. So, a new risk-factor should be discovered which is simple enough for clinical use and cost-effective, and improves the risk assessment tools that help to predict and avoid preventable mortality following cardiac surgery. Methods The prospective study was conducted, taking a total of 150 patients of coronary artery disease who underwent elective isolated off-pump coronary artery bypass. The study population was grouped according to their preoperative RDW level as Group A (RDW ≤ 14%), Group B (RDW 14–16%), and Group C (RDW ≥ 16%). The receiver operating characteristic (ROC) curve was constructed and multivariate regression analysis was done to see the predictive value of RDW for in-hospital mortality. Results The mortality rate was 2.7%, N = 150. ROC curve revealed Area Under the Curve 0.841 and p = 0.020 that indicates the RDW as the reliable predictor for in-hospital mortality. Multivariate regression analysis showed the RDW to be the only variable independently predicting in-hospital mortality after off-pump coronary artery bypass among possible haematological predictors. (OR 1.838, 95% CI 1.061–3.186, p = 0.030). Conclusion Preoperative raised RDW level is a novel predictor of in-hospital mortality after off-pump coronary artery bypass. Further studies should be done to determine the associated mechanism.

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“…Similarly, the prevalence of causes of glucose intolerance namely insulin resistance syndrome, diabetes, and central obesity are also increasing among young South Asians. This group of patients develops larger MI with greater myocardial damage and complications, the higher rate of clinical CAD events for a given degree of atherosclerosis, comparatively two-folds higher than the white population, and four-folds higher than the Chinese population [9] [10]. All these and the increasing prevalence of the conventional risk factors and high cholesterol where cholesterol levels similar to whites but higher than other Asian populations add to the disease burden [11].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of 100 Cases of Mortality after Cardiac Surgery: A Single-Center Experience in Bangladesh

Joshi¹,

Acharya²,

Bhattarai³

et al. 2020

Preprint

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Background: Vigilance ensures safety in cardiac surgery. Performance in cardiac surgery is often measured by short-term mortality. Several risk factors like advanced age, female gender, higher body mass index, decreased left ventricular function, emergent, and redo operations have appeared recurrently as poor prognostic variables. Evaluation of postoperative mortality is crucial to find loopholes to provide proper care and reduce preventable mortality after cardiac surgery in developing countries with limited infrastructures and resources. Methods: This is a retrospective study conducted in the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University. Perioperative data of 100 cases of mortality after cardiac surgery performed from 1 January 2014 to 30 May 2018 were collected from the university medical record. The data on age, gender, body mass index, preoperative investigations, diagnoses, types of operations, details of cardiopulmonary bypass, and postoperative period of the study populations were evaluated. Results: During the study period, about 1627 cases of cardiac surgery were done with an overall mortality rate of 6.15%. The mean age was 41.05 ± 20.19 (0-68) years, and 66% of patients were male. Preoperative ejection fraction (EF) of the study population was an average 56.63% ± 11.85%; 9% of the patients had EF < 40%. Off-pump coronary artery bypass (32.27%) was the most commonly performed surgery followed by mitral valve replacement (24.28%). On-pump cardiac surgery was done among 65% of the study population with a mean cross-clamp time and bypass time of 32.56 ± 11.55 minutes and 80.57 ± 18.09 minutes, respectively. Most of the mortality was found in the first two weeks after surgery. Conclusion: Mortality after cardiac surgery is multifactorial. A large-scale prospective study with comparative groups is required to find out preventable measures of mortality after cardiac surgery which will improve the quality of services provided to the patients in developing countries.

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Evaluation of 100 Cases of Mortality after Cardiac Surgery: A Single-Center Experience in Bangladesh

Joshi¹,

Acharya²,

Bhattarai³

et al. 2020

WJCS

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0

View full text Add to dashboard Cite

Background: Vigilance ensures safety in cardiac surgery. Performance in cardiac surgery is often measured by short-term mortality. Several risk factors like advanced age, female gender, higher body mass index, decreased left ventricular function, emergent, and redo operations have appeared recurrently as poor prognostic variables. Evaluation of postoperative mortality is crucial to find loopholes to provide proper care and reduce preventable mortality after cardiac surgery in developing countries with limited infrastructures and resources. Methods: This is a retrospective study conducted in the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University. Perioperative data of 100 cases of mortality after cardiac surgery performed from 1 January 2014 to 30 May 2018 were collected from the university medical record. The data on age, gender, body mass index, preoperative investigations, diagnoses, types of operations, details of cardiopulmonary bypass, and postoperative period of the study populations were evaluated. Results: During the study period, about 1627 cases of cardiac surgery were done with an overall mortality rate of 6.15%. The mean age was 41.05 ± 20.19 (0-68) years, and 66% of patients were male. Preoperative ejection fraction (EF) of the study population was an average 56.63% ± 11.85%; 9% of the patients had EF < 40%. Off-pump coronary artery bypass (32.27%) was the most commonly performed surgery followed by mitral valve replacement (24.28%). On-pump cardiac surgery was done among 65% of the study population with a mean cross-clamp time and bypass time of 32.56 ± 11.55 minutes and 80.57 ± 18.09 minutes, respectively. Most of the mortality was found in the first two weeks after surgery. Conclusion: Mortality after cardiac surgery is multifactorial. A large-scale prospective study with comparative groups is required to find out preventable measures of mortality after cardiac surgery which will improve the quality of services provided to the patients in developing countries.

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A 50-year-old female, diabetic patient with chest pain and dizziness

Cited by 3 publications

References 6 publications

Role of pre-operative red cell distribution width estimation in the prediction of in-hospital mortality after off-pump coronary artery bypass grafting

Role of pre-operative red cell distribution width estimation in the prediction of in-hospital mortality after off-pump coronary artery bypass grafting

Evaluation of 100 Cases of Mortality after Cardiac Surgery: A Single-Center Experience in Bangladesh

Evaluation of 100 Cases of Mortality after Cardiac Surgery: A Single-Center Experience in Bangladesh

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