scholarly journals Association Between Postoperative Thrombocytopenia and Outcomes After Coronary Artery Bypass Grafting Surgery

2021 ◽  
Vol 8 ◽  
Author(s):  
Jinghang Li ◽  
Dongmin Yu ◽  
Yuanyuan Song ◽  
Iokfai Cheang ◽  
Xiaowei Wang
Keyword(s):  
Intensive Care ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Perioperative Outcomes ◽  
Prolonged Stay ◽  
Increased Risk ◽  
Hospital Stays ◽  
Cabg Patients ◽  
The Impact

Objectives: The effect of postoperative thrombocytopenia on adverse events among coronary artery bypass graft (CABG) patients remains unclear. This study aims to investigate the association between postoperative thrombocytopenia and perioperative outcomes of CABG.Methods: This is a retrospective study with MIMIC-III (Medical Information Mart for Intensive Care III) database. Adult patients who underwent CABG were included to analyze the impact of thrombocytopenia in patients' outcomes. Postoperative thrombocytopenia was defined as a platelet count <100 × 109/L on the first day after CABG surgery. A multivariable logistic regression analysis was utilized to adjust the effect of thrombocytopenia on outcomes for baseline and covariates, and to determine the association with outcomes.Results: A total of 4,915 patients were included, and postoperative thrombocytopenia occurred in 696 (14.2%) patients. Postoperative thrombocytopenia was not associated with increased 28-day mortality (OR 0.75; 95% CI 0.33–1.72; P = 0.496) or in-hospital mortality (OR 0.75; 95% CI 0.34–1.63; P = 0.463) after adjusting for confounders. Regarding the secondary outcomes, it was associated with a higher risk of a prolonged stay in the intensive care unit (OR 1.53; 95% CI 1.18–1.97; P = 0.001), prolonged hospital stays (OR 1.58; 95% CI 1.21–2.06; P = 0.001), prolonged mechanical ventilation time (OR 1.67; 95% CI 1.14–2.44; P = 0.009), and a trend toward increased occurrence of massive bleeding (OR 1.41; 95% CI 1.00–2.01; P = 0.054). There was no significant association between an increased risk of prolonged vasopressor use and the continuous renal replacement therapy rate.Conclusions: Postoperative thrombocytopenia was associated with prolonged ICU and hospital stays but not with increased perioperative mortality among CABG patients.

Perioperative Outcomes of Coronary Artery Bypass Grafting: Effects of Metabolic Syndrome and Patient’s Sex

2009 ◽  
Vol 18 (5) ◽  
pp. 468-473 ◽  
Author(s):  
Marcia L. Brackbill ◽  
Christine S. Sytsma ◽  
Kristina Sykes
Keyword(s):  
Metabolic Syndrome ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Perioperative Outcomes ◽  
Hospital Death ◽  
Cabg Patients

Background Perioperative outcome data related to metabolic syndrome in coronary artery bypass graft (CABG) patients are lacking. Objective To determine the incidence of metabolic syndrome in CABG patients and whether its presence or the patient’s sex affects postoperative lengths of stay in the intensive care unit and hospital. Methods A retrospective observational study in CABG patients. Risk factors from the Society of Thoracic Surgeons’ Adult Cardiac Surgery Database were used to categorize patients as having metabolic syndrome. Perioperative outcomes were compared between patients with and without metabolic syndrome and between sexes. Outcomes were based on the operational definitions of the Society of Thoracic Surgeons. Results Among 657 patients, 333 had metabolic syndrome; 63.8% (n = 215) of women and 36.9% (n = 118) of men (P ≤ .001). Mean postoperative stays were significantly longer in patients who had metabolic syndrome. Women had longer postoperative stays than did men. Mean postoperative stay for women was 2.7 (SD, 3.4) days in the intensive care unit and 8.2 (SD, 7.1) days in the hospital, compared with 2.0 (SD, 3.8) days in the intensive care unit (P = .01) and 6.6 (SD, 6.8) days in the hospital for men (P = .003). Women with metabolic syndrome also had higher rates of in-hospital death (P = .03). Conclusion Both female patients and patients with metabolic syndrome undergoing CABG surgery are at higher risk for longer postoperative stays. Women with metabolic syndrome are the CABG patients at highest risk for in-hospital death.

Adverse Cerebral Outcomes after Coronary Artery Bypass Surgery—More Than a Decade of Experience in a Single Center

2018 ◽  
Vol 66 (06) ◽  
pp. 452-456 ◽  
Author(s):  
Carrie Consalvi ◽  
Allison Healey ◽  
Bridget Rivera ◽  
Katherine Poulin ◽  
Rephael Mohr ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Intensive Care ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Community Hospital ◽  
Artery Bypass ◽  
Historical Cohort ◽  
Increased Risk ◽  
Prior Stroke

Background Nonfatal strokes, transient ischemic attacks (TIAs), and reversible ischemic neurological deficits (RIND) after elective coronary artery bypass grafting (CABG) are devastating clinical problems. The anesthesiologist, surgical and intensive care teams in a community hospital adopted a strategy developed in an effort to minimize these adverse outcome events.The purpose of this study is to determine the incidence of and predictors for perioperative adverse neurologic events. Methods A historical cohort study of 1,108 consecutive CABG patients operated between 2002 and 2014. Outcomes were defined as (1) a new neurologic damage (a new stroke, TIA, or RIND) and (2) a new neurologic damage or 30 days mortality. Results Adverse cerebral outcomes occurred in 16 patients (1.4 percent). Nine patients had postoperative stroke, six suffered TIAs, and one had postoperative RIND.In multivariate analysis, older age (OR 1.07, 95% CI 1.01–1.14), congestive heart failure (OR 3.57, 95% CI 1.22–10.49) and prior stroke (OR 6.27, 95% CI 1.78–22.03) were significantly associated with increased risk of new neurologic damage. These parameters were also significantly associated with increased risk of the combined outcome (new neurologic damage/mortality). Conclusions A low incidence rate of adverse cerebral outcomes after CABG in community hospital can be achieved with the use of the suggested surgical intensive care, and anesthetic strategy. Advanced age, congestive heart failure, and prior stroke are associated with adverse outcomes.

scholarly journals The Impact of Preoperative Anaemia on Early Outcomes after Off-pump Coronary Artery Bypass Grafting

2021 ◽  
Vol 36 (1) ◽  
pp. 47-54
Author(s):  
Sanjay Kumar Raha ◽  
Smriti Kana Biswas ◽  
Sorower Hossain ◽  
Md Salahuddin Rahaman ◽  
Khan Muhammad Fahim Bin Enayet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Blood Transfusion ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Off Pump ◽  
Increased Risk ◽  
The Impact ◽  
Preoperative Anaemia

Introduction: In cardiac surgery, anaemia itself or combined with other risk factors has been found to be a major predictor for adverse outcome both preoperatively and postoperatively and even during extracorporeal circulation, but data about the specific tolerance of Coronary Artery Bypass Graft (CABG) patients for anaemia are conflicting and may in part be confounded by the effects of bypass surgery. Objectives: This study was performed in the National Institute of Cardiovascular Diseases (NICVD) to observe whether the early outcomes of Off-Pump CABG (OPCAB)were affected by pre-operative haematocrit levels. Methods: A total of 200 patients who underwent isolated OPCAB between January 2015 and December 2020 were retrospectively selected and purposively allocated into two groups: a)100 patients having preoperative anaemia and b) 100 patients without preoperative anaemia. Preoperative, per-operative and early post-operative variables were recorded, compiled and compared. Results: Preoperative characteristics were homogenously distributed between two groups other than haemoglobin level. Female patients had lower haemoglobin in each group. More patients of anaemic group required intraoperative and postoperative blood transfusion. The amount of blood loss and transfused blood products was also higher in anaemic patients. The ventilation time, length of ICU and post-operative hospital stay were significantly higher among anaemic patients. Among the post-operative complications, only the incidence of renal dysfunction was significantly higher among anaemic patients. Conclusion:This study has showed that anaemic patients undergoing OPCAB had an increased risk of postoperative adverse events. Importantly, the extent of preexisting comorbidities substantially affected perioperative anaemia tolerance. Therefore, preoperative risk assessment, optimization and subsequent therapeutic strategies, such as blood transfusion, should take into account both the individual level of preoperative haemoglobin and the extent of concomitant risk factors. Bangladesh Heart Journal 2021; 36(1) : 47-54

Aprotinin causes no increased risk of organ dysfuntion in coronary artery bypass procedures

2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
G Goerlach ◽  
C Immler ◽  
P Roth ◽  
T Attmann ◽  
A Boening
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Increased Risk

Early Outcomes of Coronary Endarterectomy in Patients Undergoing Coronary Artery Bypass Surgery

2016 ◽  
Vol 19 (2) ◽  
pp. 059
Author(s):  
Amin Bagheri ◽  
Ahmad Masoumi ◽  
Jamshid Bagheri
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Adverse Outcomes ◽  
Supraventricular Arrhythmia ◽  
Coronary Endarterectomy ◽  
Early Results ◽  
The Impact

<strong>Background:</strong> Coronary endarterectomy (CE) is performed as an adjunct to coronary artery bypass surgery (CABG); however, the efficacy of this technique is still controversial. We aimed to evaluate the impact of CE combined with CABG when compared with isolated CABG.<br /><strong>Methods:</strong> Patients who underwent CABG between July 2007 and June 2014 were included. 70 of 2452 patients (2.8%) underwent CE in addition to CABG. Early results were compared with isolated CABG and predictors of adverse outcome were measured in stepwise multivariate logistic regression analyses.<br /><strong>Results:</strong> The incidence of comorbidities including prior myocardial infarction, diabetes mellitus, and three-vessel coronary disease in CE patients was higher; however, mortality (4.3% versus control 3.6%; P = .762) and postoperative complications were not significantly increased in this group of patients (except supraventricular arrhythmia). Although age greater than 70 years, impaired ejection fraction, intraoperative intraaortic balloon pump, and prolonged cardiopulmonary bypass time were important predictors of adverse outcomes, CE was not associated with increased mortality or postoperative morbidities. <br /><strong>Conclusion:</strong> Despite the higher risk profile of patients who underwent CE, this technique was not identified as an independent risk factor for adverse postoperative outcomes.

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