Predictors of Increased Length of Hospital Stay in Patients with Severe Cardiomyopathy Undergoing Coronary Artery Bypass Grafting

Yu, Pey‐Jen; Lin, Dishen; Catalano, Michael A.; Cassiere, Hugh A.; Kohn, Nina; Hartman, Alan R.

doi:10.1053/j.jvca.2019.03.017

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…The Copenhagen City Heart Study was shown that the lower levels of serum albumin were significantly associated with atrial fibrillation in women, independent of incident heart disease, new‐onset heart failure, body mass index and inflammatory process 33 . Also, low serum albumin levels before isolated CABG surgery is predictive of postoperative acute kidney injury, more complicated or slower postoperative recovery, 30‐day all‐cause readmission and mortality 34‐37 . In our study, preoperative albumin levels were significantly lower in patients with POAF and found as an independent predictor of POAF.…”

Section: Discussionsupporting

confidence: 52%

“…33 slower postoperative recovery, 30-day all-cause readmission and mortality. [34][35][36][37] In our study, preoperative albumin levels were significantly lower in patients with POAF and found as an independent predictor of POAF. These findings may support the hypothesis that the basal inflammatory and/or nutritional status may contribute to the etiology of POAF.…”

Section: Resultsmentioning

confidence: 77%

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The C‐reactive protein/albumin ratio as a new predictor for postoperative atrial fibrillation after coronary artery bypass graft surgery

et al. 2020

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Background This study aimed to investigate the predictive significance of C‐reactive protein/albumin ratio for postoperative atrial fibrillation occurrence in patients who were underwent coronary artery bypass graft surgery. Methods Among 830 patients who underwent coronary artery bypass grafting with cardiopulmonary bypass between January 2016 and February 2020, 137 patients with no prior arrhythmia history were included in this cross sectional study. Results One hundred and thirty‐seven (16.5%) patients developed atrial fibrillation in postoperative period. Patients who experienced postoperative atrial fibrillation were more likely to be older but displayed similar rates of diabetes mellitus, hypertension, hypercholesterolemia, cerebrovascular disease, peripheral vascular disease and chronic obstructive pulmonary disease. For prediction of postoperative atrial fibrillation development, diagnostic odds ratio (OR) and positive likelihood ratio of C‐reactive protein/albumin ratio value (OR: 1.854; confidence interval [CI]: 1.598‐2.142; P < .001) was higher than serum C‐reactive protein and albumin levels. (OR: 1.159; CI: 1.115‐1.201; P < .001; OR: 0.438; CI: 0.258‐0.865; P < .001, respectively). Which means that C‐reactive protein/albumin ratio may detect postoperative atrial fibrillation development better C‐reactive protein itself. Conclusion Based on our results, patients who developed postoperative atrial fibrillation after coronary artery bypass grafting had significantly higher preoperative C‐reactive protein/albumin ratio levels than patients who remained in normal sinus rhythm in the postoperative period. Also, higher C‐reactive protein/albumin ratio value was one of the independent predictive factors for postoperative atrial fibrillation. Therefore, we concluded that evaluating preoperative C‐reactive protein/albumin ratio value might provide early identification of patients with high risk for postoperative atrial fibrillation.

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Section: Discussionsupporting

confidence: 52%

Section: Resultsmentioning

confidence: 77%

The C‐reactive protein/albumin ratio as a new predictor for postoperative atrial fibrillation after coronary artery bypass graft surgery

et al. 2020

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“…The study identified two significant predictors of mortality: an estimated glomerular filtration rate (eGFR) of < 45 mL/min/1.73m2 and patients with a median age of 76 years compared with their younger cohort. In another study, 201 patients with LVEF of ≤ 25% who underwent CABG between January 2012 and March 2017 were retrospectively reviewed to identify preoperative risk factors related to increased length of hospital stay or operative mortality [ 12 ]. The study demonstrated that a more extended length of hospital stay was associated with the absence of preoperative beta-blockers, low preoperative albumin levels (< 3.5 g/dl), and higher Society of Thoracic Surgeons Predicted Risk of Mortality score.…”

Section: Preoperative Managementmentioning

confidence: 99%

Preoperative, Multidisciplinary Clinical Optimization of Patients with Severely Depressed Left Ventricular Ejection Fraction Who Are Undergoing Coronary Artery Bypass Grafting

et al. 2020

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Coronary artery bypass grafting (CABG) remains a routine operation despite major advancements in angioplastic procedures. Around 200,000 CABG procedures are performed annually in the U.S. Patients who are not candidates for angioplasty intervention often have advanced coronary disease and comorbidities that raise the risk of heart failure with decreased ejection fraction to around 25%. Over the years, significant developments in various preoperative interventions have occurred; in this paper, we suggest a multidisciplinary preoperative algorithm that can be included in a regularly scheduled multidisciplinary care plan.

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“…The risk of mortality in patients subjected to CABG surgery depends on the patients' age, comorbidities, physiological functional reserve, degree of left ventricular dysfunction, the surgeons' experience, and the hospital procedure volume [8][9][10]. The operative all-cause mortality rate in our hospital was 11.2%.…”

Section: Discussionmentioning

confidence: 88%

Perioperative outcomes of coronary artery bypass graft surgery in Johannesburg, South Africa

Reiche

Mpanya

Vanderdonck

et al. 2021

J Cardiothorac Surg

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Background The perioperative complications in patients with coronary artery disease undergoing coronary artery bypass graft (CABG) surgery have been reported predominantly from developed countries, with a paucity of data from sub-Saharan Africa. We aim to report on the clinical characteristics and perioperative complications in patients with obstructive coronary artery disease, managed with CABG surgery at a tertiary academic hospital in Johannesburg, South Africa. Methods We retrospectively reviewed data from adult patients who underwent CABG surgery during a 17-year period (January 2000 – December 2017). Data was collected from the cardiothoracic surgery department’s pre- and postoperative reports, the cardiology department’s medical records, and anaesthesiology’s intra-operative reports. We collected demographic, biochemical, clinical, surgical, echocardiographic, and angiographic data. Outcomes data collected included perioperative complications and mortality. Results We analysed 1218 consecutive patient records. The study cohort consisted of 951 (78.1%) males, and the mean age was 60.1 ± 10.1 years. During the study period, 137 (11.2%) patients demised with cardiac and sepsis-related causes of death accounting for 49.6 and 37.2%, respectively. Other perioperative complications included excessive bleeding in 222 (18.2%), prolonged ventilation (exceeding 48 h) in 139 (11.4%), and sternal sepsis in 125 (10.3%). On univariate logistic regression analysis, advanced age, a lower left ventricular ejection fraction, smoking, increased cardiopulmonary bypass (CPB) time, and a higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) II were all significantly associated with mortality. The EuroSCORE II [OR: 0.15 95%CI: 0.09–0.22; p = 0.000], and prolonged CPB time [OR: 0.01 CI: 0.00–0.02; p = 0.000] were independent predictors of in-hospital all-cause mortality. Conclusions In our study, the crude perioperative mortality rate was 11.2%. Our mortality rate was significantly higher than the mortality rates reported in other developed and developing countries. To better understand the factors driving this high mortality rate, a prospective outcomes registry has been initiated, and this promises to inform on our contemporary mortality and morbidity outcomes.

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Predictors of Increased Length of Hospital Stay in Patients with Severe Cardiomyopathy Undergoing Coronary Artery Bypass Grafting

Cited by 7 publications

References 25 publications

The C‐reactive protein/albumin ratio as a new predictor for postoperative atrial fibrillation after coronary artery bypass graft surgery

The C‐reactive protein/albumin ratio as a new predictor for postoperative atrial fibrillation after coronary artery bypass graft surgery

Preoperative, Multidisciplinary Clinical Optimization of Patients with Severely Depressed Left Ventricular Ejection Fraction Who Are Undergoing Coronary Artery Bypass Grafting

Perioperative outcomes of coronary artery bypass graft surgery in Johannesburg, South Africa

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