TY - JOUR
T1 - How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery?
AU - Sung, Li Chin
AU - Chang, Chuen Chau
AU - Yeh, Chun Chieh
AU - Cherng, Yih Giun
AU - Chen, Ta Liang
AU - Liao, Chien Chang
N1 - Publisher Copyright:
© 2024 Sung et al.
PY - 2024
Y1 - 2024
N2 - Objective: 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.
AB - Objective: 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.
KW - adverse events
KW - coronary artery bypass surgery
KW - noncardiac surgeries
KW - postoperative complications
KW - postoperative mortality
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U2 - 10.2147/JMDH.S449614
DO - 10.2147/JMDH.S449614
M3 - Article
AN - SCOPUS:85185915341
SN - 1178-2390
VL - 17
SP - 743
EP - 752
JO - Journal of Multidisciplinary Healthcare
JF - Journal of Multidisciplinary Healthcare
ER -