scholarly journals Impact of diabetes on outcomes of cardiac surgery in a multiethnic Southeast Asian population

2019 ◽  
Vol 16 (6) ◽  
pp. 549-555
Author(s):  
Vikaesh Moorthy ◽  
Weiling Liu ◽  
Sophia Tsong Huey Chew ◽  
Lian Kah Ti
Keyword(s):  
Cardiac Surgery ◽  
Confidence Interval ◽  
Asian Population ◽  
Southeast Asian ◽  
Elective Cardiac Surgery ◽  
Increased Risk ◽  
Surgery Outcomes ◽  
The Impact ◽  
Asian Cohort ◽  
Cardiac Surgery Outcomes

Although diabetes is rapidly increasing in Asia and has been shown to be associated with worse cardiac surgery outcomes, no research has been done to study the impact of diabetes on cardiac surgery outcomes in a Southeast Asian cohort. Hence, this study aims to delineate the predictors and impact of diabetes after cardiac surgery in a multi-ethnic Southeast Asian cohort. We analysed data from 2831 adult patients undergoing elective cardiac surgery, from 2008 to 2010 in Singapore. Diabetes was found to significantly increase the odds of intensive care unit readmission by 1.70 (95% confidence interval 1.171–2.480, p = 0.005), postoperative infection by 1.73 (95% confidence interval 1.003–2.976, p = 0.049), acute kidney injury by 1.36 (95% confidence interval 1.137–1.626, p = 0.001), postoperative hyperglycaemia by 6.00 (95% confidence interval 4.893–7.348, p < 0.001), and new need for dialysis by 1.71 (95% 1.086–5.360, p = 0.021). In conclusion, diabetes is associated with increased risk for renal dysfunction, hyperglycaemia, and infection after cardiac surgery, similar to the relative risks of diabetes patients observed in Western populations.

The impact of obesity on cardiac surgery outcomes

2018 ◽  
Vol 33 (10) ◽  
pp. 588-594 ◽  
Author(s):  
Patrick R. Vargo ◽  
Robert J. Steffen ◽  
Faisal G. Bakaeen ◽  
Suparna Navale ◽  
Edward G. Soltesz
Keyword(s):  
Cardiac Surgery ◽  
Surgery Outcomes ◽  
The Impact ◽  
Cardiac Surgery Outcomes

Cardiac Surgery Outcomes: A Case for Increased Screening and Treatment of Obstructive Sleep Apnea

2021 ◽  
Author(s):  
Seth Wolf ◽  
Candice Wolf ◽  
Tessa C. Cattermole ◽  
Hannah J. Rando ◽  
Walter F. DeNino ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cardiac Surgery ◽  
Sleep Apnea ◽  
Obstructive Sleep ◽  
Surgery Outcomes ◽  
Cardiac Surgery Outcomes

Epicardial Adipose Tissue and Postoperative Atrial Fibrillation

2021 ◽  
Author(s):  
Petraglia Laura ◽  
Conte Maddalena ◽  
Comentale Giuseppe ◽  
Cabaro Serena ◽  
Campana Pasquale ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Adipose Tissue ◽  
Cardiac Surgery ◽  
Epicardial Adipose Tissue ◽  
Perioperative Period ◽  
Postoperative Atrial Fibrillation ◽  
Serum Samples ◽  
Monocyte Chemoattractant Protein 1 ◽  
Elective Cardiac Surgery ◽  
Increased Risk

Abstract Background. Atrial fibrillation (AF) often occurs after cardiac surgery and is associated to increased risk of stroke and mortality. Several evidence support the important role of inflammation in the pathogenesis of postoperative atrial fibrillation (POAF). It is known that an increased volume and a pro-inflammatory phenotype of epicardial adipose tissue (EAT) are both associated with AF onset in non surgical context. In the present study, we aim to evaluate whether also POAF occurrence may be triggered by an exalted production of inflammatory mediators from EAT.Methods. The study population was composed of 105 patients, with no history of paroxysmal or permanent AF, undergoing elective cardiac surgery. After clinical evaluation, all patients performed an echocardiographic study including the measurement of EAT thickness. Serum samples and EAT biopsies were collected before surgery. Levels of 10 inflammatory cytokines were measured in serum and EAT conditioned media. After surgery, cardiac rhythm was monitored for 7 days.Results. Forty-four patients (41.3%) developed POAF. As regard to cardiovascular therapy, only statin use was significantly lower in POAF patients (65.1% vs. 84.7%; p-0.032). Levels of Monocyte Chemoattractant Protein-1 (MCP-1), in both serum and EAT, were significantly higher in POAF patients (130.1 pg/ml vs. 68.7 pg/ml; p = < 0.001; 322.4 pg/ml vs. 153.4 pg/ml; p = 0.028 respectively). EAT levels of IL-6 were significantly increased in POAF patients compared to those in sinus rhythm (126.3 pg/ml vs. 23 pg/ml; p = < 0.005).ConclusionHigher EAT levels of IL6 and MCP1 are significantly associated with the occurrence of POAF. Statin therapy seems to play a role in preventing POAF. These results might pave the way for a targeted use of these drugs in the perioperative period.

Audit of Cardiac Surgery Outcomes for Low Birth Weight and Premature Infants

2018 ◽  
Vol 30 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Peter Alarcon Manchego ◽  
Michael Cheung ◽  
Diana Zannino ◽  
Russell Nunn ◽  
Yves D'Udekem ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Premature Infants ◽  
Surgery Outcomes ◽  
Cardiac Surgery Outcomes

Improving Cardiac Surgery Outcomes by Using an Interdisciplinary Clinical Pathway

AORN Journal ◽  
2018 ◽  
Vol 108 (3) ◽  
pp. 265-273
Author(s):  
Tonja Hartjes ◽  
Jamie Gilliam ◽  
Ashley Thompson ◽  
Cynthia Garvan ◽  
Linda Cowan
Keyword(s):  
Cardiac Surgery ◽  
Clinical Pathway ◽  
Surgery Outcomes ◽  
Cardiac Surgery Outcomes

The Influence of Preoperative Hematocrit Levels on Early Outcomes in Patients undergoing Cardiac Surgery

2021 ◽  
Vol 15 (10) ◽  
pp. 2817-2819
Author(s):  
Ajwad Farogh ◽  
Asma Hassan ◽  
Saira Gull ◽  
Muhammad Irfan Khan ◽  
Gohar Bashir ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Risk Factor ◽  
Hospital Stay ◽  
Heart Surgery ◽  
Common Risk Factor ◽  
Duration Of Hospital Stay ◽  
Increased Risk ◽  
The Impact ◽  
Written Informed Consent ◽  
Preoperative Anaemia

Background: Anemia is a common risk factor for cardiovascular disease. The impact of preoperative anaemia is unclear in cardiac surgery. Preoperative anaemia affects early findings in patients undergoing cardiac surgery. Aim and Objective: The main objective of current research was to investigate the impact of preoperative anaemia on early outcomes in heart surgery patients. Material and Methods: A prospective randomized clinical research was undertaken after obtaining written informed consent from patients for cardiac surgery at the PIC, Lahore between Apr 2020 and Feb 2021. A total of 120 individuals between the ages of 20 and 60 were chosen for the research. Preoperative anaemia was described as Hb levels of <13 g/dl for males and <12 g/dl in female patients undergoing cardiac surgery. Results: Total 120 patients were enrolled and stratified into two groups (60 patients each) with average age 5 ± 5.75 years. Early outcomes after surgery such as postoperative stroke (6.67 % versus 1.6 %), AF (37 % versus32 %), and duration of hospital stay > 7 days (50 % vs 41.67 %) were found to be different between anaemic and normal Hb groups. Conclusion: Preoperative anaemia can be increased risk of morbidity and mortality in patients after surgery. Low preoperative Hb found as advanced risk factor for death, renal impairment, stroke, AF and long hospital stay in our research. Keywords: Anemia, CABG, AF, MI, IABP, CPB

scholarly journals Mandatory public reporting of cardiac surgery outcomes: The 2003 to 2014 Massachusetts experience

2019 ◽  
Vol 158 (1) ◽  
pp. 110-124.e9 ◽  
Author(s):  
David M. Shahian ◽  
David F. Torchiana ◽  
Daniel T. Engelman ◽  
Thoralf M. Sundt ◽  
Richard S. D'Agostino ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Public Reporting ◽  
Surgery Outcomes ◽  
Cardiac Surgery Outcomes

scholarly journals Accuracy of B-type natriuretic peptide in a multiethnic Asian population with acute dyspnea

2020 ◽  
pp. 102490792091062
Author(s):  
Mojdeh Yeganeh ◽  
Syed Saleem Jaweed ◽  
Kelvin Siew Shenq Woei ◽  
Mohd Idzwan bin Zakaria ◽  
Alexander Loch
Keyword(s):  
Heart Failure ◽  
Confidence Interval ◽  
Receiver Operating Characteristic ◽  
Acute Heart Failure ◽  
Natriuretic Peptide ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Asian Population ◽  
Final Diagnosis ◽  
Southeast Asian

Background: Optimal cut-offs for B-type natriuretic peptide (BNP) for the diagnosis of heart failure differ based on ethnicity. There are no data for Southeast Asian patients. We aimed to define the optimal cut-off points and the strength of B-type natriuretic peptide as a predictor of heart failure in Southeast Asian multiethnic population. Methods: Bedside B-type natriuretic peptide (SOB panel (Biosite®)) was measured for patients (>50 years) presenting with dyspnea. Emergency physicians (blinded to B-type natriuretic peptide result) assessed the probability of acute heart failure on a scale of 0%–100%. Heart failure diagnosis was adjudicated by two cardiologists. Results: In all, 43% (n = 87) of the 203 dyspneic patients (54.7% males, 453% females) had a final diagnosis of acute heart failure. B-type natriuretic peptide values ranged from 3.2 to 4960 pg/mL (median, 189 pg/mL). Median B-type natriuretic peptide values of patients with the final diagnosis of “acute heart failure,” “no acute heart failure but history of heart failure,” and “no heart failure” were 600, 301, and 68 pg/mL, respectively. The optimum cut-off was 186 pg/mL. The receiver operating characteristic curve of the emergency physician’s assessment of the probability of heart failure based on clinical assessment had an area under the curve of 85% (95% confidence interval: 80%–90%). Combining receiver operating characteristic curves of physician assessment and B-type natriuretic peptide values yielded an area under the curve of 96% (95% confidence interval: 93%–98%). B-type natriuretic peptide levels less than 100 pg/mL were the strongest predictor of heart failure (odds ratio: 26.36; confidence interval: 6.85–101.41), followed by upper lobe diversion and cardiomegaly. Conclusion: The accuracy of bedside B-type natriuretic peptide was validated in a multiethnic Asian population. Optimum cut-off is 186 pg/mL. A B-type natriuretic peptide >100 pg/mL is the single strongest independent predictor of heart failure.

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