Association of acute venous thromboembolism with in-hospital outcomes of coronary artery bypass graft surgery.

Title

Association of acute venous thromboembolism with in-hospital outcomes of coronary artery bypass graft surgery.

Creator

Panhwar MS; Ginwalla M; Kalra A; Gupta T; Kolte D; Khera S; Bhatt DL; Sabik JF 3rd

Publisher

Journal of the American Heart Association

Date

2019
2019-10

Description

Background While venous thromboembolism (VTE) prophylaxis is a strong recommendation after most surgeries, it is controversial in cardiac surgeries such as coronary artery bypass grafting (CABG), because of perceived low VTE incidence and increased bleeding risk. Prior studies may not have been adequately powered to study outcomes of VTE in this population. We sought to investigate the postoperative incidence and outcomes of CABG patients using a large national inpatient database. Methods and Results We utilized the 2013 to 2014 National Inpatient Sample to identify all patients >18 years of age who underwent CABG (without concomitant valvular procedures), and had VTE during the hospital stay. We then compared clinically relevant outcomes in patients with and without VTE. We identified 331 950 CABG procedures. Of these, 1.3% (n=4205) had VTE. Patients with VTE were more likely to be older (mean 67.2±10.4 years versus 65.2±10.4 years, P<0.001). VTE was associated with higher incidence of inpatient mortality (6.8% versus 1.7%; adjusted odds ratio 1.92 [95% CI 1.40-2.65]; P<0.001) and complications. VTE was also associated with higher cost (mean±SE $81 995±$923 versus $48 909±$55) and longer length of stay (mean±SE 17.06±0.16 days versus 8.52±0.01 days). Conclusions Our analysis of >330 000 CABG procedures suggests that while postoperative VTE after CABG is rare, it is associated with increased morbidity and mortality. Randomized controlled trials are needed to identify optimal strategies for VTE prophylaxis in these patients.

Subject

venous thrombosis; coronary artery bypass; coronary artery bypass graft surgery; venous thromboembolism

Identifier

PMID: 31533551

Rights

Copyright © 2019. Published by Elsevier Inc.

Format

journalArticle

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

Pages

e013246

Issue

19

Volume

8

ISSN

2047-9980

NEOMED College

NEOMED College of Medicine

NEOMED Department

Department of Internal Medicine

Update Year & Number

June2020SubmittedList

Affiliated Hospital

Cleveland Clinic Akron General Hospital

Citation

Panhwar MS; Ginwalla M; Kalra A; Gupta T; Kolte D; Khera S; Bhatt DL; Sabik JF 3rd, “Association of acute venous thromboembolism with in-hospital outcomes of coronary artery bypass graft surgery.,” NEOMED Bibliography Database, accessed July 23, 2021, https://neomed.omeka.net/items/show/11175.

Social Bookmarking