Background
Methods
Patients
Diagnosis of CDI
Variable | CDI positive n = 1256 | |
---|---|---|
n | % | |
Laparotomy | 56 | 4.5 |
Gastrointestinal bleeding | 54 | 4.3 |
Acute abdomen and/or peritonitis and/or perforation | 20 | 1.6 |
Ileus/ischemia | 23 | 1.8 |
Pseudomembranous colitis | 35 | 2.8 |
Toxic megacolon | 7 | 0.6 |
Other abdominal complications | 20 | 1.6 |
Statistics
Results
Variable | All CDI patients n = 1256 | Bland CDI n = 1103 | Fulminant CDI n = 153 | p-Value | |||
---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD | ||
Age, y | 72.2 | 10.5 | 72.3 | 10.6 | 71.6 | 10.1 | 0.444 |
Left ventricular ejection fraction, %, | 53.9 | 14.5 | 54.4 | 14.3 | 51.0 | 15.8 | 0.013 |
Creatinine, mg/dl | 1.22 | 1.03 | 1.21 | 1.02 | 1.27 | 1.08 | 0.484 |
n | % | n | % | n | % | ||
Male | 732 | 58.3 | 631 | 57.2 | 101 | 66.0 | 0.440 |
Age > 80 years | 246 | 19.6 | 227 | 20.6 | 19 | 12.8 | 0.027 |
LVEF < 30% | 112 | 8.9 | 90 | 8.2 | 22 | 14.4 | 0.015 |
Diabetes mellitus | 468 | 37.3 | 396 | 35.9 | 72 | 47.1 | 0.009 |
Coronary heart disease | 675 | 53.7 | 596 | 54.0 | 79 | 51.6 | 0.858 |
Prior acute myocardial infarction | 313 | 24.9 | 272 | 24.7 | 41 | 26.8 | 0.551 |
Peripheral artery disease | 355 | 28.3 | 319 | 28.9 | 36 | 23.5 | 0.180 |
Pre-operative dialysis | 66 | 5.3 | 53 | 4.8 | 13 | 8.5 | 0.078 |
Hypertension | 1053 | 83.8 | 930 | 84.3 | 123 | 80.4 | 0.241 |
PAP ≥60 mmHG | 101 | 8.0 | 87 | 7.9 | 14 | 9.2 | 0.633 |
Chronic obstructive pulmonary disease | 127 | 10.1 | 108 | 9.8 | 19 | 12.4 | 0.317 |
Hyperlipidemia | 657 | 52.2 | 581 | 52.7 | 75 | 49 | 0.437 |
Nicotine abuse | 352 | 28.0 | 317 | 28.7 | 35 | 22.9 | 0.150 |
Prior cardiac surgery | 161 | 12.8 | 128 | 11.6 | 33 | 21.6 | 0.001 |
Prior malignant disease | 78 | 6.2 | 69 | 6.3 | 9 | 5.9 | 1.000 |
Pre-operative neurological dysfunction | 107 | 8.5 | 92 | 8.3 | 15 | 9.8 | 0.537 |
Pre-operative ventilation | 21 | 1.7 | 12 | 1.1 | 9 | 5.9 | < 0.001 |
Pre-operative any mechanical circulatory assist device | 32 | 2.5 | 26 | 2.4 | 6 | 4.0 | 0.477 |
NYHA class | |||||||
I | 93 | 7.4 | 88 | 8.0 | 5 | 3.3 | |
II | 330 | 26.3 | 297 | 26.9 | 33 | 21.6 | |
III | 644 | 51.3 | 559 | 50.7 | 85 | 55.6 | |
IV | 189 | 15.0 | 159 | 14.4 | 30 | 19.6 | 0.036 |
≥ III | 189 | 15.0 | 159 | 14.4 | 30 | 19.6 | 0.116 |
Body mass index ≥25.0 g/m2 | 830 | 66.1 | 725 | 65.8 | 105 | 68.6 | 0.478 |
Variable | All CDI patients n = 1256 | Bland CDI n = 1103 | Fulminant CDI n = 153 | p-Value | |||
---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD | ||
Length of surgery, min | 194.8 | 91.6 | 191.3 | 89.4 | 220.7 | 103.3 | < 0.001 |
CPB time, min | 127.6 | 55.7 | 124.8 | 53.1 | 146.0 | 67.8 | 0.001 |
Cross-clamp time, min | 82.9 | 34.7 | 81.3 | 33.5 | 94.4 | 40.5 | < 0.001 |
Time of reperfusion, min | 31.7 | 24.3 | 30.8 | 22.9 | 38.3 | 32.0 | 0.020 |
Time of circulatory arrest, min | 34.3 | 22.5 | 33.8 | 23.9 | 36.1 | 17.3 | 0.808 |
n | % | n | % | n | % | ||
Emergency surgery | 144 | 11.5 | 113 | 10.2 | 31 | 20.3 | 0.001 |
Length of surgery > 200 min | 546 | 43.5 | 465 | 42.2 | 81 | 52.9 | 0.015 |
Cross-clamp time > 130 min | 503 | 40.1 | 420 | 38.0 | 83 | 54.0 | 0.001 |
Surgery performed | |||||||
Valve | 550 | 43.8 | 485 | 44.0 | 65 | 42.5 | 0.728 |
CABG | 244 | 19.4 | 212 | 19.2 | 32 | 20.9 | 0.619 |
Aortic | 31 | 2.5 | 26 | 2.4 | 5 | 3.3 | 0.496 |
Others or combination | 431 | 34.4 | 380 | 34.5 | 51 | 33.3 | 0.785 |
Any ablation for AF | 170 | 13.5 | 152 | 13.8 | 18 | 11.8 | 0.614 |
Intra-operative any mechanical circulatory assist device | 67 | 5.3 | 52 | 4.7 | 15 | 9.8 | 0.070 |
Minimally invasive surgery | 424 | 33.8 | 389 | 35.3 | 35 | 22.9 | 0.009 |
CPB | 950 | 75.6 | 826 | 74.9 | 124 | 81.0 | 0.071 |
Circulatory arrest | 34 | 2.7 | 27 | 2.4 | 4 | 4.6 | 0.129 |
Variable | CD positive n = 1256 | Bland CDI n = 1103 | Fulminant CDI n = 153 | p-Value | |||
---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD | ||
RBC, units | 8.0 | 14.1 | 6.44 | 11.9 | 19.2 | 21.6 | < 0.001 |
FFP, units | 5.3 | 13.2 | 3.8 | 10.0 | 16.3 | 24.2 | < 0.001 |
Platelets, units | 1.2 | 3.8 | 0.9 | 3.4 | 3.4 | 5.6 | < 0.001 |
Ventilation time up to first extubation, h | 81.6 | 225.3 | 66.3 | 187.1 | 187.0 | 383.8 | < 0.001 |
Total ventilation time, h | 181.4 | 359.7 | 1384 | 289.8 | 477.6 | 585.6 | < 0.001 |
Total LOS ICU, h | 282.3 | 430.9 | 234.7 | 364.5 | 586.9 | 647.4 | < 0.001 |
Total LOS IMCU, h | 202.8 | 380.5 | 188.5 | 372.5 | 319.6 | 424.6 | 0.002 |
n | % | n | % | n | % | ||
Post-operative any mechanical circulatory assist device | 80 | 6.4 | 51 | 4.6 | 29 | 19.0 | < 0.001 |
Post-operative dialysis | 301 | 24.0 | 221 | 20.0 | 80 | 52.3 | < 0.001 |
Re-intubation | 370 | 29.5 | 286 | 25.9 | 84 | 54.9 | < 0.001 |
Tracheostomy | 197 | 15.7 | 135 | 12.2 | 62 | 40.5 | < 0.001 |
Re-thoracotomy | 169 | 13.5 | 146 | 13.2 | 23 | 15.0 | < 0.001 |
Post-operative neurological dysfunction | 948 | 75.5 | 817 | 74.1 | 131 | 85.6 | 0.002 |
> 8 units RBC | 750 | 59.7 | 616 | 55.8 | 134 | 87.6 | < 0.001 |
> 5 units FFP | 477 | 38.0 | 366 | 33.2 | 111 | 72.5 | < 0.001 |
> 2 units platelets | 144 | 11.5 | 98 | 8.9 | 46 | 30.1 | < 0.001 |
Variable | Odds Ratio | 95% CI | p-Value | |
---|---|---|---|---|
Diabetes mellitus | 1.743 | 1.154 | 2.633 | 0.008 |
Pre-operative ventilation | 3.517 | 1.323 | 9.353 | 0.012 |
Cross-clamp time > 130 min | 1.934 | 1.123 | 3.329 | 0.017 |
> 8 units RBC | 1.952 | 1.012 | 3.764 | 0.046 |
> 5 units FFP | 3.382 | 2.063 | 5.544 | < 0.001 |