Related Experiment Video
Updated: Jun 23, 2025
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Age, Renal Failure and Transfusion are Risk Predictors of Prolonged Hospital Stay after Coronary Artery Bypass
Diego Pereira Gregório de Andrade1, Fabiane Letícia de Freitas1, Gabrielle Barbosa Borgomoni1
1Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.
Insights
Older age, kidney problems, and blood transfusions during surgery predict longer hospital stays after coronary artery bypass grafting (CABG). Identifying these risk factors helps improve patient care and resource use.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
- Clinical Outcomes
Background:
- Identifying cardiovascular surgery risk factors is crucial for predicting patient outcomes and optimizing resource allocation.
- Predictability in surgical outcomes can lead to improved patient management and cost-effectiveness.
Purpose of the Study:
- To identify preoperative and intraoperative risk predictors for prolonged hospitalization after coronary artery bypass grafting (CABG).
- To analyze risk factors influencing extended hospital stays in CABG patients in São Paulo, Brazil.
Main Methods:
- Cross-sectional analysis of the REPLICCAR II database (August 2017 - July 2019).
- Primary outcome: prolonged hospital stay (PHS), defined as >14 days post-surgery.
- Univariate and multivariate logistic regression analyses were used to identify significant predictors (p <0.05).
Main Results:
- A total of 3703 CABG patients were analyzed; 6.16% experienced PHS (median 17 days).
- Independent predictors for PHS included age >60 years (OR 2.05), renal failure (OR 1.73), and intraoperative red blood cell transfusion (OR 1.32).
Conclusions:
- Age over 60, renal failure, and intraoperative red blood cell transfusion are independent predictors of prolonged hospitalization after CABG.
- These identified risk factors can inform multiprofessional strategic planning to enhance patient outcomes and resource utilization in São Paulo.
Background:
Identifying risk factors in cardiovascular surgery assists in predictability, resulting in optimization of outcomes and cost reduction.
Objective:
This study aimed to identify preoperative and intraoperative risk predictors for prolonged hospitalization after coronary artery bypass grafting (CABG) surgery in the state of São Paulo, Brazil.
Methods:
A cross-sectional analysis using data from the REPLICCAR II database, a prospective, consecutive, multicenter registry that included CABG surgeries performed between August 2017 and July 2019. The primary outcome was a prolonged hospital stay (PHS), defined as a postoperative period exceeding 14 days. Univariate and multivariate logistic regression analyses were performed to identify the predictors with significance set at p <0.05.
Results:
The median age was 63 (57-70) years and 26.55% of patients were female. Among the 3703 patients analyzed, 228 (6.16%) had a PHS after CABG, with a median hospital stay of 17 (16-20) days. Predictors of PHS after CABG included age >60 years (OR 2.05; 95% CI 1.43-2.87; p<0.001); renal failure (OR 1.73; 95% CI 1.29-2.32; p <0.001) and intraoperative red blood cell transfusion (OR 1.32; 95% CI 1.07-2.06; p=0.01).
Conclusion:
Age >60 years, renal failure, and intraoperative red blood cell transfusion were independent predictors of PHS after CABG. The identification of these variables can help in multiprofessional strategic planning aimed to enhance results and resource utilization in the state of São Paulo.
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:22Heart Failure Drugs: Diuretics
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...