Kasra Moazzami1, Elena Dolmatova1, James Maher2, Christine Gerula2, Justin Sambol3, Marc Klapholz2, Alfonso H Waller4. 1. Department of Medicine, Rutgers New Jersey Medical School, The State University of New Jersey, Newark, NJ. 2. Department of Medicine, Rutgers New Jersey Medical School, The State University of New Jersey, Newark, NJ; Division of Cardiology, Department of Medicine, Rutgers New Jersey Medical School, The State University of New Jersey, Newark, NJ. 3. Division of Cardiothoracic Surgery, Department of Surgery, Rutgers New Jersey Medical School, The State University of New Jersey, Newark, NJ. 4. Department of Medicine, Rutgers New Jersey Medical School, The State University of New Jersey, Newark, NJ; Division of Cardiology, Department of Medicine, Rutgers New Jersey Medical School, The State University of New Jersey, Newark, NJ. Electronic address: ahw22@njms.rutgers.edu.
Abstract
OBJECTIVE: To investigate the frequency and predictors of in-hospital complications among patients undergoing coronary artery bypass grafting (CABG) in the United States. DESIGN: Retrospective national database analysis SETTINGS: United States hospitals. PARTICIPANTS: A weighted sample of 1,910,236 patients undergoing CABG surgery identified from the National (Nationwide) Inpatient Sample from 2008 to 2012. INTERVENTIONS: CABG surgery MEASUREMENTS AND MAIN RESULTS: The number of CABG surgeries decreased from 436,275 in 2008 to 339,749 in 2012. The Deyo comorbidity index showed a steady increase from 2008 to 2012. The rate of in-hospital mortality decreased from 2.7% in 2008 to 2.2% in 2012 (p<0.001). The most common in-hospital complication was postoperative hemorrhage (30.4%), followed by cardiac (11.34%) and respiratory complications (2.3%). During the 5-year period, the rates of in-hospital cardiac, respiratory and infectious complications decreased (p<0.001), while the rate of postoperative hemorrhage showed a 35.8% relative increase in 2012 compared to 2008. CONCLUSION: The annual number of CABG surgeries is declining in the United States. While the burden of comorbidities is increasing, the rates of mortality and most in-hospital complications are improving. The increasing rate of postoperative bleeding necessitates the need to develop strategies to improve the risk of bleeding in this patient population.
OBJECTIVE: To investigate the frequency and predictors of in-hospital complications among patients undergoing coronary artery bypass grafting (CABG) in the United States. DESIGN: Retrospective national database analysis SETTINGS: United States hospitals. PARTICIPANTS: A weighted sample of 1,910,236 patients undergoing CABG surgery identified from the National (Nationwide) Inpatient Sample from 2008 to 2012. INTERVENTIONS: CABG surgery MEASUREMENTS AND MAIN RESULTS: The number of CABG surgeries decreased from 436,275 in 2008 to 339,749 in 2012. The Deyo comorbidity index showed a steady increase from 2008 to 2012. The rate of in-hospital mortality decreased from 2.7% in 2008 to 2.2% in 2012 (p<0.001). The most common in-hospital complication was postoperative hemorrhage (30.4%), followed by cardiac (11.34%) and respiratory complications (2.3%). During the 5-year period, the rates of in-hospital cardiac, respiratory and infectious complications decreased (p<0.001), while the rate of postoperative hemorrhage showed a 35.8% relative increase in 2012 compared to 2008. CONCLUSION: The annual number of CABG surgeries is declining in the United States. While the burden of comorbidities is increasing, the rates of mortality and most in-hospital complications are improving. The increasing rate of postoperative bleeding necessitates the need to develop strategies to improve the risk of bleeding in this patient population.
Authors: Anastassia Y Gorvitovskaia; Laura A Scrimgeour; Brittany A Potz; Nicholas C Sellke; Afshin Ehsan; Neel R Sodha; Frank W Sellke Journal: Surgery Date: 2020-03-14 Impact factor: 3.982
Authors: William S Weintraub; Deepak L Bhatt; Zugui Zhang; Sarahfaye Dolman; William E Boden; Adam P Bress; Jordan B King; Brandon K Bellows; Gabriel S Tajeu; Catherine G Derington; Jonathan Johnson; Katherine Andrade; P Gabriel Steg; Michael Miller; Eliot A Brinton; Terry A Jacobson; Jean-Claude Tardif; Christie M Ballantyne; Paul Kolm Journal: JAMA Netw Open Date: 2022-02-01