Outcomes and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction

ObjectiveTo investigate the short-term prognosis and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting (CABG) with low ejection fraction.MethodsClinical data were collected from 765 patients who underwent CABG with an ejection fraction of less...

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Main Authors: Yang Zhao, Xu Yu, Xiaolong Ma, Liang Zhang, Zehui Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2024.1513149/full
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author Yang Zhao
Xu Yu
Xiaolong Ma
Liang Zhang
Zehui Wang
Zehui Wang
Zehui Wang
author_facet Yang Zhao
Xu Yu
Xiaolong Ma
Liang Zhang
Zehui Wang
Zehui Wang
Zehui Wang
author_sort Yang Zhao
collection DOAJ
description ObjectiveTo investigate the short-term prognosis and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting (CABG) with low ejection fraction.MethodsClinical data were collected from 765 patients who underwent CABG with an ejection fraction of less than 40% between 2019 and 2023 at Anhui Chest Hospital and Beijing Anzhen Hospital, Capital Medical University. The patients were categorized into a in-hospital mortality group (n = 38) and a in-hospital survival group (n = 727), based on whether they died within 30 days post-operation. Univariate and multivariate logistic regression analyses were employed to identify risk factors for in-hospital mortality. The relationship between these risk factors and the likelihood of in-hospital mortality was assessed using restricted cubic splines (RCS). Additionally, predictive values were evaluated by plotting receiver operating characteristic curves (ROC).ResultsIn-hospital mortality occurred in 38 out of the 765 patients, resulting in an incidence rate of 4.97%. Compared to the survival group, those in the mortality group exhibited significantly higher rates of exploratory thoracotomy, intra-aortic balloon pump usage, extracorporeal membrane oxygenation application, gastrointestinal bleeding incidents, and acute renal failure occurrences. Independent risk factors for in-hospital mortality included preoperative age, left ventricular ejection fraction (LVEF), fasting glucose levels (Glu), and glomerular filtration rate (eGFR). Conversely, standardized preoperative administration of oral nitrates and aspirin as well as intraoperative utilization of internal mammary arteries emerged as protective factors against in-hospital mortality. ROC analysis revealed predictive efficiencies for age at 68.5%, LVEF at 76.6%, Glu at 60.5%, while eGFR demonstrated a predictive efficiency of 78.1%.ConclusionThe incidence of in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction is correlated with several factors, including advanced age, LVEF, Glu, eGFR, and the standardized preoperative administration of oral nitrates and aspirin. These findings serve as a guide for enhancing the in-hospital prognosis for this patient population in clinical practice.
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spelling doaj-art-1b387bbffc774b29936b419fd3af0a532025-08-20T02:13:31ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-02-011110.3389/fcvm.2024.15131491513149Outcomes and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fractionYang Zhao0Xu Yu1Xiaolong Ma2Liang Zhang3Zehui Wang4Zehui Wang5Zehui Wang6Department of Cardiovascular Surgery, Anhui Chest Hospital, Hefei, Anhui, ChinaDepartment of Cardiovascular Surgery, Anhui Chest Hospital, Hefei, Anhui, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Capital Medical University Beijing, Beijing, ChinaDepartment of Cardiovascular Surgery, Anhui Chest Hospital, Hefei, Anhui, ChinaDepertment of Cardiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaShanxi Medical University, Taiyuan, Shanxi, ChinaShanxi Innovation Center for Integrated Management of Hypertension, Hyperlipidemia and Hyperglycemia Correlated with Cardiovascular and Cerebrovascular Diseases, Taiyuan, Shanxi, ChinaObjectiveTo investigate the short-term prognosis and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting (CABG) with low ejection fraction.MethodsClinical data were collected from 765 patients who underwent CABG with an ejection fraction of less than 40% between 2019 and 2023 at Anhui Chest Hospital and Beijing Anzhen Hospital, Capital Medical University. The patients were categorized into a in-hospital mortality group (n = 38) and a in-hospital survival group (n = 727), based on whether they died within 30 days post-operation. Univariate and multivariate logistic regression analyses were employed to identify risk factors for in-hospital mortality. The relationship between these risk factors and the likelihood of in-hospital mortality was assessed using restricted cubic splines (RCS). Additionally, predictive values were evaluated by plotting receiver operating characteristic curves (ROC).ResultsIn-hospital mortality occurred in 38 out of the 765 patients, resulting in an incidence rate of 4.97%. Compared to the survival group, those in the mortality group exhibited significantly higher rates of exploratory thoracotomy, intra-aortic balloon pump usage, extracorporeal membrane oxygenation application, gastrointestinal bleeding incidents, and acute renal failure occurrences. Independent risk factors for in-hospital mortality included preoperative age, left ventricular ejection fraction (LVEF), fasting glucose levels (Glu), and glomerular filtration rate (eGFR). Conversely, standardized preoperative administration of oral nitrates and aspirin as well as intraoperative utilization of internal mammary arteries emerged as protective factors against in-hospital mortality. ROC analysis revealed predictive efficiencies for age at 68.5%, LVEF at 76.6%, Glu at 60.5%, while eGFR demonstrated a predictive efficiency of 78.1%.ConclusionThe incidence of in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction is correlated with several factors, including advanced age, LVEF, Glu, eGFR, and the standardized preoperative administration of oral nitrates and aspirin. These findings serve as a guide for enhancing the in-hospital prognosis for this patient population in clinical practice.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1513149/fullcoronary artery bypass graftingcardiac insufficiencyin-hospital mortalityrisk factorsLVEF
spellingShingle Yang Zhao
Xu Yu
Xiaolong Ma
Liang Zhang
Zehui Wang
Zehui Wang
Zehui Wang
Outcomes and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction
Frontiers in Cardiovascular Medicine
coronary artery bypass grafting
cardiac insufficiency
in-hospital mortality
risk factors
LVEF
title Outcomes and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction
title_full Outcomes and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction
title_fullStr Outcomes and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction
title_full_unstemmed Outcomes and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction
title_short Outcomes and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction
title_sort outcomes and risk factors associated with in hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction
topic coronary artery bypass grafting
cardiac insufficiency
in-hospital mortality
risk factors
LVEF
url https://www.frontiersin.org/articles/10.3389/fcvm.2024.1513149/full
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