Impact of Post-operative Complications after Cardiac Surgery on Long-term Survival

Abstract

Background -The impact of post-operative complications on long-term survival is not well characterized. We sought to study the prevalence of post-operative complications after cardiac surgery and their impact on long-term survival. Methods -Operative survivors (n=26,221) who underwent coronary artery bypass grafting (CABG) (n=13054, 49.8%), valve surgery (n=8667, 33.1%) or combined CABG and valve surgery (n=4500, 17.2%) from 1993 to 2019 were included in the study. Records were reviewed for post-operative complications and long-term survival. The associations between post-operative complications and survival were assessed using a Cox-proportional model. Results -Complications occurred in 17,463 (66.6%) of 26,221 operative survivors. A total of 17 post-operative complications were analyzed. Post-operative blood product use was the commonest (n=12397, 47.3%),

Success in long‐term outcome after cardiac surgery: Rise from an uncomplicated immediate postoperative course

“…Third, Bening et al 5 demonstrate an association between impaired left atrial contractility and atrial fibrillation while prevention was achieved through cardiac monitoring, potassium, and magnesium supplementation. This association could have been further explored by Pahwa et al 1 …”

“…In conclusion, Pahwa et al 1 have provided both impetus and direction for future research into the management of postoperative complications after cardiac surgery. Ultimately, their research moves us closer to a clinical risk prediction model for postoperative complications which would allow us to toggle each complication individually.…”

“…In‐hospital complications after cardiac surgery have represented the Achilles heel for early and long‐term survival rate, especially in high‐risk patients. In the present issue of the Journal, Pahwa et al 1 present the outcomes and survival rate of 26,221 patients following cardiac surgery procedures. They divided the patients into three groups (coronary artery bypass surgery [CABG] vs. CABG plus valve vs only valve surgery) and looked specifically at complication rates and how each complication affected the early and long‐term survival rate.…”

“…Investigators have shown that the rates of postoperative complications are mostly influenced by patient‐specific comorbidities 2 . Therefore, an STS score in the study by Pahwa et al 1 would have been ad adjunct that could have clarified and divided the patients into specific risk populations. This would have evidenced which were the most frequently occurring complications and which were those with the highest impact on the survival rate based on the STS risk score.…”

“…Tachibana et al 3 are to be commented as they evidenced how aortic cross‐clamping versus side‐clamping versus beating‐heart operations affect the stroke rate. In the study by Pahwa et al, 1 these differences were not included.…”