How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery?
Li-Chin Sung,1– 4 Chuen-Chau Chang,5– 7 Chun-Chieh Yeh,8,9 Yih-Giun Cherng,5,10 Ta-Liang Chen,5,7,11 Chien-Chang Liao5– 7,12,13 1Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 2Division of Cardiology, Depar...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2024-02-01
|
| Series: | Journal of Multidisciplinary Healthcare |
| Subjects: | |
| Online Access: | https://www.dovepress.com/how-long-after-coronary-artery-bypass-surgery-can-patients-have-electi-peer-reviewed-fulltext-article-JMDH |
| _version_ | 1797301925706727424 |
|---|---|
| author | Sung LC Chang CC Yeh CC Cherng YG Chen TL Liao CC |
| author_facet | Sung LC Chang CC Yeh CC Cherng YG Chen TL Liao CC |
| author_sort | Sung LC |
| collection | DOAJ |
| description | Li-Chin Sung,1– 4 Chuen-Chau Chang,5– 7 Chun-Chieh Yeh,8,9 Yih-Giun Cherng,5,10 Ta-Liang Chen,5,7,11 Chien-Chang Liao5– 7,12,13 1Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 2Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; 3Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan; 4Department of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 5Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 6Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; 7Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan; 8Department of Surgery, China Medical University Hospital, Taichung, Taiwan; 9Department of Surgery, University of Illinois, Chicago, IL, USA; 10Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; 11Department of Anesthesiology, Wang Fang Hospital, Taipei Medical University, Taipei, Taiwan; 12Research Center of Big Data and Meta‑Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; 13School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, TaiwanCorrespondence: Chien-Chang Liao, Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing Street, Taipei, 11031, Taiwan, Tel +886-2-2737-2181, ext. 8310, Fax +886-2-2736-7344, Email ccliao@tmu.edu.tw; jacky48863027@yahoo.com.twObjective: To evaluate the complications and mortality after noncardiac surgeries in patients who underwent previous coronary artery bypass grafting (CABG).Methods: We used insurance data and identified patients aged ≥ 20 years undergoing noncardiac surgeries between 2010 and 2017 in Taiwan. Based on propensity-score matching, we selected an adequate number of patients with a previous history of CABG (within preoperative 24 months) and those who did not have a CABG history, and both groups had balanced baseline characteristics. The association of CABG with the risk of postoperative complications and mortality was estimated (odds ratio [OR] and 95% confidence interval [CI]) using multiple logistic regression analysis.Results: The matching procedure generated 2327 matched pairs for analyses. CABG significantly increased the risks of 30-day in-hospital mortality (OR 2.28, 95% CI 1.36– 3.84), postoperative pneumonia (OR 1.49, 95% CI 1.12– 1.98), sepsis (OR 1.49, 95% CI 1.17– 1.89), stroke (OR 1.53, 95% CI 1.17– 1.99) and admission to the intensive care unit (OR, 1.75, 95% CI 1.50– 2.05). The findings were generally consistent across most of the evaluated subgroups. A noncardiac surgery performed within 1 month after CABG was associated with the highest risk for adverse events, which declined over time.Conclusion: Prior history of CABG was associated with postoperative pneumonia, sepsis, stroke, and mortality in patients undergoing noncardiac surgeries. Although we raised the possibility regarding deferral of non-critical elective noncardiac surgeries among patients had recent CABG when considering the risks, critical or emergency surgeries were not in the consideration of delay surgery, especially cancer surgery.Keywords: adverse events, coronary artery bypass surgery, noncardiac surgeries, postoperative complications, postoperative mortality |
| first_indexed | 2024-03-07T23:29:35Z |
| format | Article |
| id | doaj.art-5cb15f64259f43ac8a61ebe0e22ef60f |
| institution | Directory Open Access Journal |
| issn | 1178-2390 |
| language | English |
| last_indexed | 2024-03-07T23:29:35Z |
| publishDate | 2024-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Multidisciplinary Healthcare |
| spelling | doaj.art-5cb15f64259f43ac8a61ebe0e22ef60f2024-02-20T17:10:12ZengDove Medical PressJournal of Multidisciplinary Healthcare1178-23902024-02-01Volume 1774375290557How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery?Sung LCChang CCYeh CCCherng YGChen TLLiao CCLi-Chin Sung,1– 4 Chuen-Chau Chang,5– 7 Chun-Chieh Yeh,8,9 Yih-Giun Cherng,5,10 Ta-Liang Chen,5,7,11 Chien-Chang Liao5– 7,12,13 1Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 2Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; 3Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan; 4Department of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 5Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 6Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; 7Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan; 8Department of Surgery, China Medical University Hospital, Taichung, Taiwan; 9Department of Surgery, University of Illinois, Chicago, IL, USA; 10Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; 11Department of Anesthesiology, Wang Fang Hospital, Taipei Medical University, Taipei, Taiwan; 12Research Center of Big Data and Meta‑Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; 13School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, TaiwanCorrespondence: Chien-Chang Liao, Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing Street, Taipei, 11031, Taiwan, Tel +886-2-2737-2181, ext. 8310, Fax +886-2-2736-7344, Email ccliao@tmu.edu.tw; jacky48863027@yahoo.com.twObjective: To evaluate the complications and mortality after noncardiac surgeries in patients who underwent previous coronary artery bypass grafting (CABG).Methods: We used insurance data and identified patients aged ≥ 20 years undergoing noncardiac surgeries between 2010 and 2017 in Taiwan. Based on propensity-score matching, we selected an adequate number of patients with a previous history of CABG (within preoperative 24 months) and those who did not have a CABG history, and both groups had balanced baseline characteristics. The association of CABG with the risk of postoperative complications and mortality was estimated (odds ratio [OR] and 95% confidence interval [CI]) using multiple logistic regression analysis.Results: The matching procedure generated 2327 matched pairs for analyses. CABG significantly increased the risks of 30-day in-hospital mortality (OR 2.28, 95% CI 1.36– 3.84), postoperative pneumonia (OR 1.49, 95% CI 1.12– 1.98), sepsis (OR 1.49, 95% CI 1.17– 1.89), stroke (OR 1.53, 95% CI 1.17– 1.99) and admission to the intensive care unit (OR, 1.75, 95% CI 1.50– 2.05). The findings were generally consistent across most of the evaluated subgroups. A noncardiac surgery performed within 1 month after CABG was associated with the highest risk for adverse events, which declined over time.Conclusion: Prior history of CABG was associated with postoperative pneumonia, sepsis, stroke, and mortality in patients undergoing noncardiac surgeries. Although we raised the possibility regarding deferral of non-critical elective noncardiac surgeries among patients had recent CABG when considering the risks, critical or emergency surgeries were not in the consideration of delay surgery, especially cancer surgery.Keywords: adverse events, coronary artery bypass surgery, noncardiac surgeries, postoperative complications, postoperative mortalityhttps://www.dovepress.com/how-long-after-coronary-artery-bypass-surgery-can-patients-have-electi-peer-reviewed-fulltext-article-JMDHadverse eventscoronary artery bypass surgerynoncardiac surgeriespostoperative complicationspostoperative mortality |
| spellingShingle | Sung LC Chang CC Yeh CC Cherng YG Chen TL Liao CC How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery? Journal of Multidisciplinary Healthcare adverse events coronary artery bypass surgery noncardiac surgeries postoperative complications postoperative mortality |
| title | How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery? |
| title_full | How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery? |
| title_fullStr | How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery? |
| title_full_unstemmed | How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery? |
| title_short | How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery? |
| title_sort | how long after coronary artery bypass surgery can patients have elective safer non cardiac surgery |
| topic | adverse events coronary artery bypass surgery noncardiac surgeries postoperative complications postoperative mortality |
| url | https://www.dovepress.com/how-long-after-coronary-artery-bypass-surgery-can-patients-have-electi-peer-reviewed-fulltext-article-JMDH |
| work_keys_str_mv | AT sunglc howlongaftercoronaryarterybypasssurgerycanpatientshaveelectivesafernoncardiacsurgery AT changcc howlongaftercoronaryarterybypasssurgerycanpatientshaveelectivesafernoncardiacsurgery AT yehcc howlongaftercoronaryarterybypasssurgerycanpatientshaveelectivesafernoncardiacsurgery AT cherngyg howlongaftercoronaryarterybypasssurgerycanpatientshaveelectivesafernoncardiacsurgery AT chentl howlongaftercoronaryarterybypasssurgerycanpatientshaveelectivesafernoncardiacsurgery AT liaocc howlongaftercoronaryarterybypasssurgerycanpatientshaveelectivesafernoncardiacsurgery |