A model that predicts morbidity and mortality after coronary artery bypass graft surgery

Magovern, James A.; Sakert, Tamara; Benckart, Daniel H.; Burkholder, John A.; Liebler, George A.; Magovern, George J.

doi:10.1016/s0735-1097(96)00310-5

Cited by 126 publications

(85 citation statements)

References 12 publications

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“…Another mortality predictor introduced in 1992 was the Northern New England score which was developed for isolated CABG operations and included preoperative dialysis dependency as a surrogate for high serum level of creatinine [140] . Nilsson et al [3] and Magovern et al [141] developed another risk algorithm to be applied in isolated CABG with promising results compared to a group of 18 risk models.…”

Section: Creatinine and The Outcome Prediction In Cardiac Surgerymentioning

confidence: 99%

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Najafi

2014

WJC

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Serum creatinine is still the most important determinant in the assessment of perioperative renal function and in the prediction of adverse outcome in cardiac surgery. Many biomarkers have been studied to date; still, there is no surrogate for serum creatinine measurement in clinical practice because it is feasible and inexpensive. High levels of serum creatinine and its equivalents have been the most important preoperative risk factor for postoperative renal injury. Moreover, creatinine is the mainstay in predicting risk models and risk factor reduction has enhanced its importance in outcome prediction. The future perspective is the development of new definitions and novel tools for the early diagnosis of acute kidney injury largely based on serum creatinine and a panel of novel biomarkers.

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Section: Creatinine and The Outcome Prediction In Cardiac Surgerymentioning

confidence: 99%

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Najafi

2014

WJC

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“…Using univariate and multivariate logistic models, Zindrou and coworkers 1 found that a low hemoglobin level was a predictor of in-hospital death after CABG. In the risk-prediction model of Magovern and associates, 2 anemia was an independent predictor for mortality or morbidity. Kulier and colleagues 3 reported that a low preoperative hemoglobin level was an independent risk factor for renal and neurological complications, whereas an increase in cardiac events was due to other factors associated with preoperative anemia, such as renal dysfunction.…”

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confidence: 91%

Preoperative Hemoglobin Level as a Predictor of Survival After Coronary Artery Bypass Grafting

et al. 2009

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Background— The predictive value of the preoperative hemoglobin value after coronary artery bypass grafting (CABG) has not been well established. We studied how the preoperative hemoglobin level affects the survival of patients after CABG. Late mortality was compared with that of a general population. Methods and Results— Early and late mortality of all consecutive patients undergoing isolated CABG between January 1998 and December 2007 were determined. Patients were classified into 4 groups stratified by preoperative hemoglobin level. The cutoff point for anemia was 13 g/dL for men and 12 g/dL for women. Expected survival of a matched general Dutch population cohort was obtained from the database of the Dutch Central Bureau for Statistics. After the exclusion of 122 patients who were lost to follow-up and 481 patients with missing preoperative hemoglobin levels, complete data were obtained in 10 025 patients. Multivariate logistic regression analyses revealed anemia to be an independent risk factor for higher early mortality. Cox regression analyses revealed low hemoglobin level, both as a continuous variable and as a dichotomous variable (anemia), to be a predictor of higher late mortality. Compared with expected survival, patients with the lowest preoperative hemoglobin levels had a worse outcome, whereas patients with the highest hemoglobin levels had a better outcome. Conclusions— A lower preoperative hemoglobin level is an independent predictor of late mortality in patients undergoing CABG, whereas anemia is a risk factor for early and late mortality. Compared with the general population, anemic patients had worse survival than expected, whereas nonanemic patients had better survival than expected.

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“…However, in the study of Weber et al, there was no association between preoperative anemia and increased surgical site infection [24]. Other studies found a non-significant relationship, or one with a smaller odds ratios [25,26]. The Kulier et al study showed a significant relationship between preoperative low Hgb and non-cardiac-but not cardiac-complications [1].…”

Section: Discussionmentioning

confidence: 92%

Preoperative anemia associated in-hospital mortality and morbidity in isolated coronary artery bypass graft surgery

et al. 2010

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AbstractAnemia is an indisputable finding in patients scheduled for coronary artery bypass graft (CABG) that can occur any time preoperatively. In presence of severe coronary artery disease, anemia can dramatically affect surgical outcomes. Therefore, we conducted this study to determine the effect of low preoperative hemoglobin (Hgb) on postoperative outcome in patients who underwent coronary artery bypass graft (CABG). In all, 4432 patients who had undergone isolated CABG at Tehran Heart Center over the 2-year period from March 2006 to February 2008 were studied. All medical records of the aforementioned patients were derived from our hospital surgery data bank. After adjustment for confounders, the association of different preoperative levels of Hgb with risk of cardiac, pulmonary, infectious, and ischemic complications, and also with prolonged ventilation and resource utilization, were assessed in a multivariable model. After adjustment for confounders that may affect mortality and morbidities, we found that cardiac, infectious, ischemic, and pulmonary complications, as well as postoperative mortality, were significantly higher in anemic patients compared to those with normal Hgb levels. In addition, total ventilation time, total intensive care unit hour stay (ICU), hospital length of stay (HLOS), and postsurgery length of stay (PLOS) were significantly longer in anemic patients. We concluded that isolated CABG patients with preoperative anemia have significantly higher mortality and morbidity, and use more health care resources. Preoperative anemia is an independent variable for increased resource utilization, morbidity, and mortality.

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A model that predicts morbidity and mortality after coronary artery bypass graft surgery

Abstract: Analysis of preoperative patient variables can predict patients at increased risk for morbidity or mortality, or both, after bypass surgery. Increased morbidity results in higher costs. Different strategies for high and low risk patients should be used in cost reduction efforts.

Cited by 126 publications

References 12 publications

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Preoperative Hemoglobin Level as a Predictor of Survival After Coronary Artery Bypass Grafting

Preoperative anemia associated in-hospital mortality and morbidity in isolated coronary artery bypass graft surgery

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