The Impact of Moderate–to–End-Stage Renal Failure on Outcomes After Coronary Artery Bypass Graft Surgery

2010 ◽  
Vol 24 (4) ◽  
pp. 574-579 ◽  
Author(s):  
Joanna Chikwe ◽  
Javier G. Castillo ◽  
Parwis B. Rahmanian ◽  
Adanna Akujuo ◽  
David H. Adams ◽  
...  
Keyword(s):  
Renal Failure ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
End Stage Renal Failure ◽  
End Stage ◽  
The Impact

Increased Risk of Sternal Complications in Patients with Plasma Cell Dyscrasias (PCDs) Undergoing Coronary Artery Bypass Graft (CABG)

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5319-5319
Author(s):  
Malini M Patel ◽  
Shams B Bufalino ◽  
Anai N Kothari ◽  
Paul C Kuo ◽  
Sucha Nand
Keyword(s):  
Renal Failure ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Odds Ratio ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Control Group ◽  
Artery Bypass Graft ◽  
Increased Risk

Abstract Introduction: Skeletal events, including fractures, form an important part of the clinical spectrum of PCDs. Skeletal surveys, even though less sensitive than MRI, remain the usual method of screening for lytic lesions and fractures in these patients but may miss subtle abnormalities. Patients undergoing a CABG normally require a midline sternal incision, which may increase the risk of a skeletal event. Patients with PCDs also have an increased risk of infection, thrombosis, and renal failure. To our knowledge, there is no published data about complications of cardiothoracic surgery in these patients. We hypothesized that patients with PCDs will have a higher risk of complications when compared to those without such history. Methods: Data on patients who underwent non-urgent coronary artery bypass graft (CABG) surgery from 2007 to 2011 was obtained by querying the Healthcare Cost and Utilization State Inpatient Databases for Florida and California. Information was available only for the inpatient stay plus a 30-day follow-up period. Diagnoses of multiple myeloma and monoclonal gammopathy of unknown significance (MGUS) were identified using ICD-9-CM codes. Mixed-effects logistic models were used to measure the association between PCDs and postoperative sternal complications controlling for demographics and comorbidity. Secondary outcomes of study in bivariate analysis included postoperative complications and 30-day readmission rates. Results: A total of 54,422 patients who underwent non-urgent CABG were identified. Of those patients, 500 were known to have a PCD. Ninety two percent of those patients (462 out of 500) had a diagnosis of MGUS. Median age was 66.6 years for the control group and 65.4 years in the PCDs group, and the male to female ratio was equal in both cohorts. In the PCD group, there was a statistically significant higher incidence of anemia, obesity, and renal failure prior to surgical intervention. Sternal infections occurred in 519 (1%) of the patients in the control group versus 18 (3.6%) of the patients in PCDs group (p<0.001). The 30-day all cause readmission rate was similar between the two groups but the 30-day sternal complication rate was significantly higher in the PCDs group (6.8% vs 3.7%; p<0.001). The odds ratio of sternal infection was 3.84 (CI 2.38-6.20) and the odds ratio of sternal dehiscence was 3.87 (CI 1.98-7.57) in the PCDs group when compared to the control group, both of which are statistically significant. Similarly, the odds ratio of sternal complications at 30-days was 1.92 (CI 1.35-2.73) in the PCDs group when compared to the control group. There were no statistically significant differences in the rates of postoperative myocardial infarctions, strokes, urinary tract infections, acute kidney injury, pneumonias, deep venous thrombosis, and gastrointestinal complications between the two cohorts. Conclusions: Our data shows that patients with PCDs have a lower hemoglobin level, renal insufficiency, and are obese at the time of coronary bypass surgery. It is important to note that the majority of the subjects in our study population had MGUS, a condition usually associated with little morbidity. Nonetheless, our cohort of patients with PCDs had a significantly increased risk of sternal wound infection and dehiscence. The treating physicians should be aware of these risks and patients should be informed. Prospective studies will be necessary to confirm and extend these findings. Disclosures No relevant conflicts of interest to declare.

The Impact of Postoperative Atrial Fibrillation on Neurocognitive Outcome After Coronary Artery Bypass Graft Surgery

2002 ◽  
Vol 94 (2) ◽  
pp. 290-295 ◽  
Author(s):  
Timothy O. Stanley ◽  
G. Burkhard Mackensen ◽  
Hilary P. Grocott ◽  
William D. White ◽  
James A. Blumenthal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Postoperative Atrial Fibrillation ◽  
Artery Bypass Graft ◽  
Neurocognitive Outcome ◽  
The Impact

scholarly journals The Impact of Cardiac Rehabilitation on the Level of Anxiety and Symptoms of Depression in Patients after Coronary Revascularization

2021 ◽  
Vol 75 (1) ◽  
pp. 939-946
Author(s):  
Adam Rafał Poliwczak ◽  
Karolina Jędrzejczak-Pospiech ◽  
Bogumiła Polak ◽  
Jan Błaszczyk ◽  
Robert Irzmański
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Cardiac Rehabilitation ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Depression Symptoms ◽  
Artery Bypass Graft ◽  
Symptoms Of Depression ◽  
The Impact

Abstract Introduction The coexistence of depression and anxiety disorder significantly worsens the results of treatment and increases the risk of recurrent cardiovascular incidents. The aim of the study was to assess the impact of cardiac rehabilitation on anxiety and depression symptoms in patients after interventional cardiology or coronary artery bypass graft (CABG). Material and Methods The study enrolled 40 participants aged 70.75±7.38 years, treated interventionally for ACS or undergoing urgent coronary artery bypass graft (CABG). Patients participated in 3-week stationary early cardiac rehabilitation. At the beginning and end of the study, the Beck Depression Inventory (BDI) and Spielberger’s State-Trait Anxiety Inventory (STAI) were performed. Results 92.5% of subjects had at least one comorbidity, mostly hypertension (67.5%) and heart failure (60.0%). At the beginning the BDI level was 14.55±6.47; depression symptoms were present in 65% of subjects. At the end, BDI decreased significantly to 8.28±5.26; p<0.001. BDI was statistically significantly higher at the beginning and end in women than in men (17.94±7.07 vs. 11.78±4.40; p<0.05 and 10.56±5.90 vs. 6.41±3.88; p<0.01). Persons before rehabilitation were characterized by medium and low levels of STAI-X1 anxiety (31.80±7.24 and STAI-X2: 35.98±8.29). Finally, anxiety decreased statistically significantly to 26.40±6.30 and 29.80±6.57; p<0.001. At the beginning and end, it strongly correlated positively with the severity of depressive symptoms (STAI-X1 R=0.76; p<0.001, STAI-X2 R=0.70; p<0.001 and R=0.76; p<0.001, R=0.70; p<0.001). Conclusions Cardiac rehabilitation contributes significantly to reducing anxiety levels and reducing symptoms of depression. Implementation of these interventions as soon as possible brings the best results, contributing to reducing the risk of coronary events.

scholarly journals The Impact of the Medicaid Healthcare-Associated Condition Program on Mediastinitis Following Coronary Artery Bypass Graft

2018 ◽  
Vol 39 (6) ◽  
pp. 694-700 ◽  
Author(s):  
Heather E. Hsu ◽  
Alison Tse Kawai ◽  
Rui Wang ◽  
Maximilian S. Jentzsch ◽  
Chanu Rhee ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Knee Replacement ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Medicaid Program ◽  
Program Effect ◽  
The Impact

OBJECTIVEIn 2012, the Centers for Medicare and Medicaid Services expanded a 2008 program that eliminated additional Medicare payment for mediastinitis following coronary artery bypass graft (CABG) to include Medicaid. We aimed to evaluate the impact of this Medicaid program on mediastinitis rates reported by the National Healthcare Safety Network (NHSN) compared with the rates of a condition not targeted by the program, deep-space surgical site infection (SSI) after knee replacement.DESIGNInterrupted time series with comparison group.METHODSWe included surveillance data from nonfederal acute-care hospitals participating in the NHSN and reporting CABG or knee replacement outcomes from January 2009 through June 2017. We examined the Medicaid program’s impact on NHSN-reported infection rates, adjusting for secular trends. The data analysis used generalized estimating equations with robust sandwich variance estimators.RESULTSDuring the study period, 196 study hospitals reported 273,984 CABGs to the NHSN, resulting in 970 mediastinitis cases (0.35%), and 294 hospitals reported 555,395 knee replacements, with 1,751 resultant deep-space SSIs (0.32%). There was no significant change in incidence of either condition during the study. Mediastinitis models showed no effect of the 2012 Medicaid program on either secular trend during the postprogram versus preprogram periods (P=.70) or an immediate program effect (P=.83). Results were similar in sensitivity analyses when adjusting for hospital characteristics, restricting to hospitals with consistent NHSN reporting or incorporating a program implementation roll-in period. Knee replacement models also showed no program effect.CONCLUSIONSThe 2012 Medicaid program to eliminate additional payments for mediastinitis following CABG had no impact on reported mediastinitis rates.Infect Control Hosp Epidemiol 2018;39:694–700

The Impact of Postoperative Atrial Fibrillation on Neurocognitive Outcome After Coronary Artery Bypass Graft Surgery

2002 ◽  
Vol 94 (2) ◽  
pp. 290-295
Author(s):  
Timothy O. Stanley ◽  
G. Burkhard Mackensen ◽  
Hilary P. Grocott ◽  
William D. White ◽  
James A. Blumenthal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Postoperative Atrial Fibrillation ◽  
Artery Bypass Graft ◽  
Neurocognitive Outcome ◽  
The Impact

The Impact of Aprotinin on Coronary Artery Bypass Graft Patency

CHEST Journal ◽  
1994 ◽  
Vol 106 (5) ◽  
pp. 1370-1375 ◽  
Author(s):  
Glenn W. Laub ◽  
Jerome B. Riebman ◽  
Chao Chen ◽  
Mark S. Adkins ◽  
William A. Anderson ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Graft Patency ◽  
Artery Bypass Graft ◽  
The Impact
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