Risk factors and in-hospital mortality in Chinese patients undergoing coronary artery bypass grafting: Analysis of a large multi-institutional Chinese database

Zheng, Zhe; Zhang, Lu; Hu, Shengshou; Li, Xi; Yuan, Xin; Gao, Huawei

doi:10.1016/j.jtcvs.2011.10.012

Cited by 18 publications

(15 citation statements)

References 13 publications

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“…[9,11,23] However, a recent Chinese study still suggested COPD to be an independent risk factor for postoperative mortality after CABG. [24] To further clarify this divergence, the present meta-analysis on this topic of interest was performed.…”

Section: Discussionmentioning

confidence: 99%

Postoperative outcomes of patients with chronic obstructive pulmonary disease undergoing coronary artery bypass grafting surgery

Zhao

Yang

et al. 2019

Medicine

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Introduction: Chronic obstructive pulmonary disease (COPD) is a frequent comorbid disease in patients undergoing coronary artery bypass grafting (CABG) surgery, with an incidence ranging from 4% to 20.5%. Conventionally, COPD was recognized as a surgical contraindication to CABG. Because of the recent improvements in surgical techniques, anesthesia, and postoperative management, CABG has been performed more commonly in patients with COPD. However, studies have shown the various effects of COPD on postoperative morbidity and mortality after CABG, and this remains to be well defined. Objectives: To compare the postoperative outcomes after CABG between patients with and those without COPD. Methods: A systematic search was conducted in the Cochrane Library, PubMed, EmBase, and Ovid databases (until May 10, 2018). Studies comparing perioperative results and mortality outcomes after CABG between patients with and those without COPD were evaluated independently by 2 reviewers to identify the potentially eligible studies. Review Manager and STATA software were used for statistical analyses. Results: No significant difference in the mortality rates were found between patients with and those without COPD. COPD was associated with a higher respiratory failure rate (odds ratio [OR] = 4.01; 95% CI: 1.19–13.51, P = .03; P <.001 for heterogeneity), higher pneumonia rate (OR = 2.92; 95% CI: 2.37–3.60, P <.00001; P = .73 for heterogeneity), higher stroke rate (OR = 2.91; 95% CI: 1.37–6.18, P = .005; P = .60 for heterogeneity), higher renal failure rate (OR = 1.60; 95% CI: 1.30–1.97, P <.00001; P = .19 for heterogeneity), and higher wound infection rate (OR = 2.16; 95% CI: 1.21–3.88, P = .01; P = .53 for heterogeneity) after CABG. Conclusions: Patients with COPD were at higher risks for developing postoperative morbidities, particularly pneumonia, respiratory failure, stroke, renal failure, and wound infection. Although COPD was not associated with a higher risk of mortality, caution should be taken when a patient with COPD is indicated for CABG, considering the higher odds of postoperative complications involving the respiratory system and others.

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Section: Discussionmentioning

confidence: 99%

Postoperative outcomes of patients with chronic obstructive pulmonary disease undergoing coronary artery bypass grafting surgery

Zhao

Yang

et al. 2019

Medicine

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“…Moreover, ACE-I or ARB use before surgery and high BUN levels were associated with worse outcome, in accordance with the findings of previous studies. An observational study using a multicenter registered database of patients who underwent CABG in China revealed that preoperative atrial fibrillation was associated with mortality [23]. The GOPCABE trial also showed that preoperative atrial fibrillation was adversely associated with the combined endpoint, including death, myocardial infarction, dialysis, and revascularization, and even the 30-day mortality rate of CABG patients [24].…”

Section: Discussionmentioning

confidence: 99%

Prognostic implications of preoperative chronic kidney disease and anemia in patients undergoing coronary artery bypass graft surgery

et al. 2016

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“…Significant risk factors included in both the SinoSCORE and derived SinoSCORE model are summarised in table 3 10. Factors that were found to be significant in the original SinoSCORE, but lacked significance in the derived SinoSCORE model included body mass index, preoperative atrial fibrillation, COPD and non-elective surgery.…”

Section: Resultsmentioning

confidence: 99%

East meets West: the influence of racial, ethnic and cultural risk factors on cardiac surgical risk model performance

et al. 2018

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Objective To explore the impact of racial and ethnic diversity on the performance of cardiac surgical risk models, the Chinese SinoSCORE was compared with the Society of Thoracic Surgeons (STS) risk model in a diverse American population. Methods The SinoSCORE risk model was applied to 13 969 consecutive coronary artery bypass surgery patients from twelve American institutions. SinoSCORE risk factors were entered into a logistic regression to create a 'derived' SinoSCORE whose performance was compared with that of the STS risk model. results Observed mortality was 1.51% (66% of that predicted by STS model). The SinoSCORE 'low-risk' group had a mortality of 0.15%±0.04%, while the medium-risk and high-risk groups had mortalities of 0.35%±0.06% and 2.13%±0.14%, respectively. The derived SinoSCORE model had a relatively good discrimination (area under of the curve (AUC)=0.785) compared with that of the STS risk score (AUC=0.811; P=0.18 comparing the two). However, specific factors that were significant in the original SinoSCORE but that lacked significance in our derived model included body mass index, preoperative atrial fibrillation and chronic obstructive pulmonary disease. Conclusion SinoSCORE demonstrated limited discrimination when applied to an American population. The derived SinoSCORE had a discrimination comparable with that of the STS, suggesting underlying similarities of physiological substrate undergoing surgery. However, differential influence of various risk factors suggests that there may be varying degrees of importance and interactions between risk factors. Clinicians should exercise caution when applying risk models across varying populations due to potential differences that racial, ethnic and geographic factors may play in cardiac disease and surgical outcomes.

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Risk factors and in-hospital mortality in Chinese patients undergoing coronary artery bypass grafting: Analysis of a large multi-institutional Chinese database

Cited by 18 publications

References 13 publications

Postoperative outcomes of patients with chronic obstructive pulmonary disease undergoing coronary artery bypass grafting surgery

Postoperative outcomes of patients with chronic obstructive pulmonary disease undergoing coronary artery bypass grafting surgery

Prognostic implications of preoperative chronic kidney disease and anemia in patients undergoing coronary artery bypass graft surgery

East meets West: the influence of racial, ethnic and cultural risk factors on cardiac surgical risk model performance

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