Background
Methods
Setting and patient selection
Measurement of the HRQL and definitions
Statistical analyses
Results
Primary endpoint (all cardiac surgery patients)
Baseline characteristics
All (n = 803) | R (n = 627) | NR (n = 176) | p-value | |
---|---|---|---|---|
Demographics | ||||
Baseline SF 36 physical domain score | 59 [45–73] | 56 [42–69] | 71 [55–86] | < 0.001a |
Body Mass Index (kg/m2) | 27 [25–30] | 27 [25–30] | 27 [25–29] | 0.891 |
Comorbidities | ||||
CVA (%) | 2 | 1.6 | 1.1 | 0.658 |
Neurologic dysfunction (%) | 2 | 2.1 | 1.7 | 0.757 |
Cardiac status | ||||
Unstable AP (%) | 3.5 | 3.2 | 4.5 | 0.387 |
EuroSCORE II | 1.6 [1.1–2.7] | 1.5 [1.0–2.6] | 1.8 [1.2–3.0] | 0.030a |
Age (years) | 69 [62–75] | 69 [62–75] | 70 [62–75] | 0.127 |
Gender Male (%) | 77 | 78 | 73 | 0.144 |
Serum Creatinine (umol/l) | 84 [73–96] | 84 [73–96] | 82 [72–95] | 0.347 |
Extracardiac arteriopathy (%) | 8 | 7.5 | 9.1 | 0.487 |
Poor mobility (%) | 2.0 | 2.1 | 1.7 | 0.757 |
Previous cardiac surgery (%) | 3.1 | 3.0 | 3.4 | 0.798 |
Chronic lung disease (%) | 12 | 11.6 | 10.8 | 0.755 |
Active endocarditis (%) | 0.7 | 0.6 | 1.1 | 0.498 |
Critical preoperative state (%) | 0.5 | 0.3 | 1.1 | 0.174 |
Diabetes (%) | 18.9 | 17.5 | 23.9 | 0.059 |
NYHA Class III or IV (%) | 54 | 53.5 | 55.1 | 0.692 |
Angina CCS Class IV (%) | 1.9 | 2.2 | 0.6 | 0.150 |
LVEF (%) | 0.254 | |||
Good | 77 | 78 | 75 | |
Moderate | 18 | 17 | 22 | |
Poor | 4 | 4 | 2 | |
Missing | 1 | 1 | 1 | |
Recent MI (%) | 21 | 19.6 | 27.8 | 0.019a |
Pulmonary hypertension (%) | 12.6 | 12.8 | 11.9 | 0.654 |
Urgency (%) | 0.231 | |||
Elective | 50 | 51.4 | 45.5 | |
Urgent | 48.7 | 47.5 | 52.3 | |
Emergency | 1.3 | 1.1 | 2.3 | |
Weight of intervention (%) | 0.456 | |||
Isolated CABG | 69.4 | 68.6 | 72.2 | |
Single Non CABG | 13.1 | 13.1 | 13.1 | |
2 Procedures | 15.4 | 16.4 | 11.9 | |
3 Procedures | 2.1 | 1.9 | 2.8 | |
Surgery on thoracic aorta (%) | 2.7 | 3.0 | 1.7 | 0.341 |
Intraoperative characteristics | ||||
Aortic cross-clamp (min) | 60 [42–83] | 61 [42–83] | 59 [44–81] | 0.358 |
ECC (min) | 91 [64–118] | 92 [63–119] | 86 [64–116] | 0.382 |
Postoperative characteristics | ||||
Infection (%) | 5.6 | 4.5 | 9.7 | 0.008a |
First detubation (hour) | 3.2 [2.5–4.7] | 3.2 [2.5–4.6] | 3.2 [2.5–4.9] | 0.868 |
Re-sternotomy < 30 d (%) | 4.1 | 4.0 | 4.0 | 0.765 |
ICU days (n) | 1.0 [1.0–1.0] | 1.0 [1.0–1.0] | 1.0 [1.0–1.0] | 0.450 |
ICU stay extended (%) | 5.9 | 5.9 | 5.7 | 0.913 |
CVA (%) | 0.3 | 0.2 | 0.6 | 0.336 |
Readmission ICU (%) | 1.0 | 0.8 | 1.7 | 0.285 |
Readmission < 30 days after discharge (%) | 0.9 | 0.5 | 2.3 | 0.026a |
MI (incl. Perioperative MI) (%) | 3.1 | 3.2 | 2.8 | 0.740 |
MI (excl. Perioperative MI) (%) | 0.9 | 0.6 | 1.7 | 0.142 |
PCI < 1 year (%) | 2.2 | 1.3 | 5.7 | < 0.001a |
Intraoperative and postoperative characteristics
Multivariate analysis of all cardiac surgery patients
p-value | OR | 95% CI | |
---|---|---|---|
Baseline SF36 physical domain score | < 0.001 | 0.954 | 0.942–0.965 |
Diabetes | 0.001 | 0.437 | 0.265–0.720 |
Female sex | 0.003 | 0.492 | 0.307–0.789 |
Infection | < 0.001 | 0.240 | 0.109–0.525 |
PCI < 1 year | < 0.001 | 0.113 | 0.036–0.349 |
Secondary endpoint (isolated CABG patients)
Baseline characteristics
All (n = 555) | R (n = 426) | NR (n = 129) | p-value | |
---|---|---|---|---|
Demographics | ||||
Baseline SF 36 physical domain score | 60 [46–73] | 56 [44–69] | 73 [57–88] | < 0.001a |
Body Mass Index (kg/m2) | 27.1 [24.8–29.4] | 27.0 [24.8–29.6] | 27.2 [24.8–29.1] | 0.728 |
Comorbidities | ||||
CVA (%) | 0.7 | 0.9 | 0.0 | 0.270 |
Neurologic dysfunction (%) | 1.1 | 1.2 | 0.8 | 0.702 |
Cardiac status | ||||
Unstable AP (%) | 4.9 | 4.5 | 6.2 | 0.421 |
EuroSCORE II | 1.37 [0.98–2.12] | 1.3 [0.9–2.0] | 1.7 [1.1–2.5] | 0.021a |
Age (years) | 68.4 [61.8–74.0] | 67.9 [61.7–73.7] | 69.5 [62.2–74.4] | 0.204 |
Gender Male (%) | 83.6 | 85.9 | 76.0 | 0.003a |
Serum Creatinine (umol/l) | 84 [24.8–29.4] | 84 [75–95] | 82 [72–95] | 0.762 |
Extracardiac arteriopathy (%) | 8.1 | 7.5 | 10.1 | 0.350 |
Poor mobility (%) | 1.1 | 1.2 | 0.8 | 0.702 |
Previous cardiac surgery (%) | 1.3 | 1.4 | 0.8 | 0.573 |
Chronic lung disease (%) | 10.6 | 10.6 | 10.9 | 0.926 |
Active endocarditis (%) | 0.0 | 0.0 | 0.0 | 1.000 |
Critical preoperative state (%) | 0.5 | 0.2 | 1.6 | 0.074 |
Diabetes (%) | 20.2 | 18.8 | 24.8 | 0.135 |
NYHA Class III or IV (%) | 57.1 | 55.9 | 61.3 | 0.281 |
Angina CCS Class IV (%) | 2.3 | 2.8 | 0.8 | 0.180 |
LVEF (%) | 0.116 | |||
Good | 78.9 | 81.0 | 72.1 | |
Moderate | 17.5 | 15.7 | 23.3 | |
Poor | 2.7 | 2.6 | 3.1 | |
Missing | 0.9 | 0.7 | 1.6 | |
Recent MI (%) | 29.2 | 26.5 | 38.0 | 0.012a |
Pulmonary hypertension (%) | 1.6 | 1.6 | 1.6 | 0.942 |
Urgency (%) | 0.268 | |||
Elective | 39.1 | 40.8 | 33.3 | |
Urgent | 59.3 | 58.0 | 63.6 | |
Emergency | 1.6 | 1.2 | 3.1 | |
Weight of intervention (%) | ||||
Isolated CABG | 99.3 | 99.5 | 98.4 | 0.452 |
Single Non CABG | 0.0 | 0.0 | 0.0 | |
2 Procedures | 0.5 | 0.2 | 1.6 | |
3 Procedures | 0.2 | 0.2 | 0.0 | |
Surgery on thoracic aorta (%) | 0.2 | 0.0 | 0.8 | 0.069 |
Intraoperative characteristics | ||||
Aortic cross-clamp (min) | 51.0 [37.0–70.0] | 51 [37–70.3]] | 52 [37–70.5] | 0.479 |
ECC (min) | 80.0 [56.0–103.0] | 80 [55–103] | 81 [58.5–105.5] | 0.343 |
Postoperative characteristics | ||||
Infection (%) | 5.0 | 3.5 | 10.1 | 0.007a |
First detubation (hour) | 3.0 [2.5–4.4] | 3.0 [2.5–4.3] | 3.1 [2.5–4.9] | 0.412 |
Re-sternotomy < 30 d (%) | 3.8 | 4.0 | 3.1 | 0.750 |
ICU days (n) | 1.0 [1.0–1.0] | 1.0 [1.0–1.0] | 1.0 [1.0–1.0] | 0.666 |
ICU stay extended (%) | 2.9 | 3.1 | 2.3 | 0.666 |
CVA (%) | 0.2 | 0 | 0.8 | 0.180 |
Readmission ICU (%) | 0.5 | 0.5 | 1.6 | 0.889 |
Readmission < 30 days after discharge (%) | 1.1 | 0.5 | 3.1 | 0.042a |
MI (incl. perioperative) (%) | 3.6 | 3.8 | 3.1 | 0.739 |
MI (excl. perioperative) (%) | 0.9 | 0.7 | 1.6 | 0.699 |
PCI < 1 yr (%) | 2.9 | 1.4 | 7.8 | 0.001a |
Intraoperative and postoperative characteristics
Multivariate analysis of isolated CABG patients
p-value | OR | 95% CI | |
---|---|---|---|
Baseline SF36 physical domain score | < 0.001 | 0.954 | 0.942–0.967 |
Diabetes | 0.004 | 0.443 | 0.257–0.766 |
Female sex | < 0.001 | 0.341 | 0.194–0.601 |
Infection | < 0.001 | 0.195 | 0.078–0.488 |
PCI < 1 year | < 0.001 | 0.106 | 0.032–0.353 |