scholarly journals Cardiac magnetic resonance findings predict increased resource utilization in elective coronary artery bypass grafting

2008 ◽  
Vol 114 (6) ◽  
pp. 423-430 ◽  
Author(s):  
Colin Berry ◽  
Lukas U. Zimmerli ◽  
Tracey Steedman ◽  
John E. Foster ◽  
Henry J. Dargie ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Magnetic Resonance ◽  
Coronary Artery Bypass ◽  
Resource Utilization ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Cabg Surgery

Morbidity following CABG (coronary artery bypass grafting) is difficult to predict and leads to increased healthcare costs. We hypothesized that pre-operative CMR (cardiac magnetic resonance) findings would predict resource utilization in elective CABG. Over a 12-month period, patients requiring elective CABG were invited to undergo CMR 1 day prior to CABG. Gadolinium-enhanced CMR was performed using a trueFISP inversion recovery sequence on a 1.5 tesla scanner (Sonata; Siemens). Clinical data were collected prospectively. Admission costs were quantified based on standardized actual cost/day. Admission cost greater than the median was defined as ‘increased’. Of 458 elective CABG cases, 45 (10%) underwent pre-operative CMR. Pre-operative characteristics [mean (S.D.) age, 64 (9) years, mortality (1%) and median (interquartile range) admission duration, 7 (6–8) days] were similar in patients who did or did not undergo CMR. In the patients undergoing CMR, eight (18%) and 11 (24%) patients had reduced LV (left ventricular) systolic function by CMR [LVEF (LV ejection fraction) <55%] and echocardiography respectively. LE (late enhancement) with gadolinium was detected in 17 (38%) patients. The average cost/day was $2723. The median (interquartile range) admission cost was $19059 ($10891–157917). CMR LVEF {OR (odds ratio), 0.93 [95% CI (confidence interval), 0.87–0.99]; P=0.03} and SV (stroke volume) index [OR 1.07 (95% CI, 1.00–1.14); P=0.02] predicted increased admission cost. CMR LVEF (P=0.08) and EuroScore tended to predict actual admission cost (P=0.09), but SV by CMR (P=0.16) and LV function by echocardiography (P=0.95) did not. In conclusion, in this exploratory investigation, pre-operative CMR findings predicted admission duration and increased admission cost in elective CABG surgery. The cost-effectiveness of CMR in risk stratification in elective CABG surgery merits prospective assessment.

scholarly journals Is Periodontitis a Predictor for an Adverse Outcome in Patients Undergoing Coronary Artery Bypass Grafting? A Pilot Study

2021 ◽  
Vol 10 (4) ◽  
pp. 818
Author(s):  
Stefan Reichert ◽  
Susanne Schulz ◽  
Lisa Friebe ◽  
Michael Kohnert ◽  
Julia Grollmitz ◽  
...  
Keyword(s):  
Risk Factor ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Surface Area ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Cabg Surgery

Periodontitis is a risk factor for atherosclerosis and coronary vascular disease (CVD). This research evaluated the relationship between periodontal conditions and postoperative outcome in patients who underwent coronary artery bypass grafting (CABG). A total of 101 patients with CVD (age 69 years, 88.1% males) and the necessity of CABG surgery were included. Periodontal diagnosis was made according to the guidelines of the Centers for Disease Control and Prevention (CDC, 2007). Additionally, periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) were determined. Multivariate survival analyses were carried out after a one-year follow-up period with Cox regression. All study subjects suffered from periodontitis (28.7% moderate, 71.3% severe). During the follow-up period, 14 patients (13.9%) experienced a new cardiovascular event (11 with angina pectoris, 2 with cardiac decompensation, and 1 with cardiac death). Severe periodontitis was not significant associated with the incidence of new events (adjusted hazard ratio, HR = 2.6; p = 0.199). Other risk factors for new events were pre-existing peripheral arterial disease (adjusted HR = 4.8, p = 0.030) and a history of myocardial infarction (HR = 6.1, p = 0.002). Periodontitis was not found to be an independent risk factor for the incidence of new cardiovascular events after CABG surgery.

Abstract 120: Regional Variation in Infection Rates after Coronary Artery Bypass Grafting

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Donald Likosky ◽  
Mallika Kommareddi ◽  
Theodore Boeve ◽  
Steven Harrington ◽  
Robert Holmes ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Case Mix ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Cabg Surgery ◽  
Medical Centers ◽  
Cannulation Site

Introduction: Healthcare acquired infections (HAIs) are a leading cause of morbidity and mortality after cardiac surgery. Prior work has identified a number of patient-related risk factors associated with HAIs. Hypothesis: We hypothesized that rates of HAIs would differ across institutions, in part attributed to differences in case mix. Methods: We enrolled 27,663 patients undergoing isolated coronary artery bypass grafting (CABG) surgery at 33 medical centers in Michigan between 1/1/2008 - 6/30/2012. Overall HAIs included pneumonia, sepsis/septicemia, deep sternal wound, thoracotomy, and harvest/cannulation site infections. We excluded patients presenting with endocarditis. Predicted rates of HAIs were estimated using multivariable logistic regression. Results: Overall rate of HAI was 5.3% (1454 of 27,663) [pneumonia: 3.7% (n=1020), sepsis/septicemia: 1.0% (n=266), deep sternal wound: 0.7% (n=184), harvest/cannulation site: 0.6% (n=163), multiple infections: 0.6% (n=169)]. While predicted risk of HAI differed in absolute terms by 4.1% across centers (4.2% - 8.3%, min:max), observed rates varied from 1.3% to 20.8%, p<0.01 (Figure). Conclusions: There was a 16-fold variability in rates of HAIs across medical centers among patients undergoing isolated CABG surgery. This variability could not be explained by patient case mix. Future work should focus on the impact of other factors (e.g. organizational and systems of clinical care) on risk of HAIs.

scholarly journals Resource Utilization Related to Atrial Fibrillation After Coronary Artery Bypass Grafting

2002 ◽  
Vol 11 (3) ◽  
pp. 228-238 ◽  
Author(s):  
Marilyn Hravnak ◽  
Leslie A. Hoffman ◽  
Melissa I. Saul ◽  
Thomas G. Zullo ◽  
Gayle R. Whitman
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Resource Utilization ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Onset Atrial Fibrillation ◽  
New Onset

• Background Studies of resource utilization by patients with new-onset atrial fibrillation after coronary artery bypass grafting have addressed only length of stay and bed charges.• Objective To compare resource utilization between patients with new-onset atrial fibrillation and patients without atrial fibrillation after isolated coronary artery bypass grafting.• Methods Retrospective review of clinical and administrative electronic databases for 720 subjects who underwent isolated coronary artery bypass grafting with cardiopulmonary bypass in 25 months at one medical center. The prevalence of atrial fibrillation was determined, and resource utilization in various hospital cost centers was compared between subjects with and without atrial fibrillation.• Results The prevalence of new-onset atrial fibrillation was 33.1%. Compared with subjects without atrial fibrillation, subjects with atrial fibrillation had a longer stay (5.8 ± 2.4 vs 4.4 ± 1.2 days, P&lt; .001), more days receiving mechanical ventilation (P=.002) and oxygen therapy (P&lt; .001), and higher rates of readmission to the intensive care unit (4.6% vs 0.2%, P&lt; .001). Subjects with atrial fibrillation also had more laboratory tests (P&lt; .001) and more days receiving cardiac drugs, heparin, diuretics, and electrolytes. Subjects with atrial fibrillation had higher total postoperative charges ($57261 ± $17 101 vs $50 905 ± $10 062, P = .001), a mean difference of $6356. The mean differences were greatest for bed charges ($1642), laboratory charges ($1215), pharmacy ($989), and respiratory care ($582).• Conclusions The economic impact of atrial fibrillation after coronary artery bypass grafting has been underestimated.

Morbid Obesity Is Associated With Increased Resource Utilization in Coronary Artery Bypass Grafting

2012 ◽  
Vol 94 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Justin C. Choi ◽  
Faisal G. Bakaeen ◽  
Lorraine D. Cornwell ◽  
Tam K. Dao ◽  
Joseph S. Coselli ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Resource Utilization ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

A Nano-Based P1Cminimum Probe to Monitor Thrombosis in Grafts and Improve Cardiac Function After Coronary Artery Bypass Grafting Surgery

2021 ◽  
Vol 17 (10) ◽  
pp. 1951-1959
Author(s):  
Qiyong Wu ◽  
Xiaoqiang Tang ◽  
Haifeng Shi ◽  
Yong Zhang ◽  
Tao Wang ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Cardiac Function ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Cabg Surgery ◽  
Activated Platelets

Magnetic resonance imaging is widely used to identify and monitor thrombi in grafted vessels following coronary artery bypass grafting surgery (CABG). We produced a biosensor, P1Cm-SPIO-Cy5.5, composed of P1Cm peptide, superparamagnetic iron oxide nanoparticles (SPIO), and polyethylene glycol (PEG), for use in MRI thrombus imaging. Activated platelets induced by adenosine diphosphate were used for combination tests in vitro. A rat model of common carotid artery thrombosis was used for anti-thrombus experiments in vivo. P1Cm-SPIO-Cy5.5 remains stable in vitro and has good anticoagulation capacity. It can bind specifically to activated platelets and thrombi. In rats that underwent bypass surgery, P1Cm-SPIO-Cy5.5 could detect and label thrombi over a long period, and prevent thrombosis in grafted vessels. P1Cm-SPIO-Cy5.5 improved cardiac function in rats following CABG surgery. P1Cm-SPIO-Cy5.5 is a potential sensor for use in MRI for the early diagnosis and prevention of thrombosis after CABG surgery.

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