A score to estimate 30-day mortality after intensive care admission after cardiac surgery

Lamarche, Yoan; Elmi-Sarabi, Mahsa; Ding, Lillian; Abel, James G.; Sirounis, Demetrios; Denault, André

doi:10.1016/j.jtcvs.2016.11.039

Cited by 25 publications

(17 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although some studies have stated that transfusion or RBC is an independent risk factor for mortality, others have shown that transfusion may play a secondary role and that other undetermined factors related to gender may also be important. 44,45…”

Section: Discussionmentioning

confidence: 99%

Gender and intraoperative blood transfusion: analysis of 54,122 non-reoperative coronary revascularization procedures

et al. 2018

View full text Add to dashboard Cite

Background: Previous studies have shown that women undergoing isolated coronary artery bypass graft (CABG) surgery have an increased risk for postoperative morbidity and mortality when compared to men. Additionally, recent evidence suggests that blood transfusions are independently associated with an increased risk of adverse outcome. Methods: We evaluated gender differences in the risk of intraoperative red blood cell (RBC) transfusion during CABG surgery. Consecutive, non-reoperative CABG procedures performed across 196 institutions between April 2012 and May 2015 were retrospectively reviewed. Gender differences for intraoperative transfusion were evaluated with a multi-variable binary logistic regression model, adjusting for age, blood volume (Nadler formula to normalize for height and weight), body mass index, procedure acuity, net extracorporeal circuit prime volume, use of autologous priming, first hematocrit (Hct) in the operating room (OR), nadir Hct on cardiopulmonary bypass (CPB), volume added on CPB, ultrafiltration volume, urine output on CPB and procedure duration. Results: Among 54,122 patients (25.3% female), 21.6% (n = 11,701) received a RBC transfusion. Compared to men, female patients were older (66 years vs. 64 years, p<0.001), had lower blood volumes (4.3L vs. 5.6L, p<0.001) and a lower preoperative Hct (32.9% vs. 37.2%, p<0.001). Transfusion rates were threefold higher in women versus men (45.1% vs. 13.7%, p<0.001). After adjustment for independent predictors of intraoperative transfusion, women remained at increased risk versus men (OR = 1.30, 95%CI = 1.19−1.43). Conclusions: Women have an increased risk of intraoperative RBC transfusion versus men. After adjusting for height and weight, much of this risk is due to gender differences in preoperative Hct and blood volume; however, a residual significant risk remained after adjustment. Perfusion strategies aimed at gender differences may minimize unnecessary transfusions. Future study on the impact of gender on transfusion practice in cardiac surgery is warranted.

show abstract

Section: Discussionmentioning

confidence: 99%

Gender and intraoperative blood transfusion: analysis of 54,122 non-reoperative coronary revascularization procedures

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Although some studies have stated that transfusion of RBC is an independent risk factor for mortality, others have shown that transfusion may play a secondary role and that other undetermined factors related to gender may be important. 44,45 In our study, patients who were smaller or anemic benefited more from AP than ANH in maintaining higher on-CPB hematocrits with lower transfusions.…”

Section: Discussionmentioning

confidence: 61%

The effectiveness of acute normolvolemic hemodilution and autologous prime on intraoperative blood management during cardiac surgery

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Only recently, morbidity has been incorporated in these models as they provide a marker for the quality of life (53). So far, most risk scores for postoperative outcomes are based on preoperative inputs and lack incorporation of intraoperative variables to improve on performance (54).…”

Section: Postoperativementioning

confidence: 99%

Machine learning methods for perioperative anesthetic management in cardiac surgery patients: a scoping review

Rellum¹,

Schuurmans²,

Ven³

et al. 2021

J Thorac Dis

View full text Add to dashboard Cite

Background: Machine learning (ML) is developing fast with promising prospects within medicine and already has several applications in perioperative care. We conducted a scoping review to examine the extent and potential limitations of ML implementation in perioperative anesthetic care, specifically in cardiac surgery patients. Methods: We mapped the current literature by searching three databases: MEDLINE (Ovid), EMBASE (Ovid), and Cochrane Library. Articles were eligible if they reported on perioperative ML use in the field of cardiac surgery with relevance to anesthetic practices. Data on the applicability of ML and comparability to conventional statistical methods were extracted. Results: Forty-six articles on ML relevant to the work of the anesthesiologist in cardiac surgery were identified. Three main categories emerged: (I) event and risk prediction, (II) hemodynamic monitoring, and (III) automation of echocardiography. Prediction models based on ML tend to behave similarly to conventional statistical methods. Using dynamic hemodynamic or ultrasound data in ML models, however, shifts the potential to promising results. Conclusions: ML in cardiac surgery is increasingly used in perioperative anesthetic management. The majority is used for prediction purposes similar to conventional clinical scores. Remarkable ML model performances are achieved when using real-time dynamic parameters. However, beneficial clinical outcomes of ML integration have yet to be determined. Nonetheless, the first steps introducing ML in perioperative anesthetic care for cardiac surgery have been taken.

show abstract

A score to estimate 30-day mortality after intensive care admission after cardiac surgery

Abstract: Preoperative and intraoperative variables can be used on admission to a cardiac surgical ICU to estimate 30-day mortality. The score could be used for risk stratification after cardiac surgery and evaluation of performance of cardiac surgical ICUs.

Cited by 25 publications

References 34 publications

Gender and intraoperative blood transfusion: analysis of 54,122 non-reoperative coronary revascularization procedures

Gender and intraoperative blood transfusion: analysis of 54,122 non-reoperative coronary revascularization procedures

The effectiveness of acute normolvolemic hemodilution and autologous prime on intraoperative blood management during cardiac surgery

Machine learning methods for perioperative anesthetic management in cardiac surgery patients: a scoping review

Contact Info

Product

Resources

About