Nomogram for predicting major bleeding after off-pump coronary artery bypass grafting

Area of Science:

• Cardiovascular Surgery
• Medical Prediction Modeling

Background:

• Off-pump coronary artery bypass grafting (CABG) is a complex procedure.
• Major bleeding is a significant complication following CABG, impacting patient outcomes.
• Accurate prediction of bleeding risk is crucial for effective patient management.

Purpose of the Study:

• To develop and validate a novel nomogram for predicting major bleeding after off-pump CABG.
• To identify key predictors of major bleeding in patients undergoing off-pump CABG.
• To assess the clinical utility of the developed nomogram in surgical decision-making.

Main Methods:

• Retrospective analysis of 541 patients undergoing off-pump isolated primary CABG (January 2012 - December 2022).
• Multivariate analysis to identify independent predictors of major bleeding.
• Construction and validation of a predictive nomogram using ROC analysis and calibration.
• Decision curve analysis (DCA) to evaluate clinical benefit.

Main Results:

• Age, body mass index, hemoglobin, sodium, blood urea nitrogen, and operation time were identified as independent predictors of major bleeding.
• The developed nomogram demonstrated excellent discrimination and calibration.
• DCA indicated that using the nomogram for decision-making provides greater clinical benefit compared to treating all or no patients.

Conclusions:

• The developed nomogram accurately predicts major bleeding risk following off-pump CABG.
• This tool can aid in clinical decision-making, patient treatment strategies, and consultation services.
• The nomogram offers a valuable addition to the management of patients undergoing off-pump CABG.