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The Impact of Silent Liver Disease on Hospital Length of Stay Following Isolated Coronary Artery Bypass Grafting Surgery.
Suffredini, Giancarlo; Le, Lan; Lee, Seoho; Gao, Wei Dong; Robich, Michael P; Aziz, Hamza; Kilic, Ahmet; Lawton, Jennifer S; Voegtline, Kristin; Olson, Sarah; Brown, Charles Hugh; Lima, Joao A C; Das, Samarjit; Dodd-O, Jeffrey M.
Afiliación
  • Suffredini G; Department of Anesthesiology and Critical Care Medicine, Division of Cardiac Anesthesia, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Le L; Department of Anesthesiology and Critical Care Medicine, Division of Cardiac Anesthesia, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Lee S; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Gao WD; Department of Anesthesiology and Critical Care Medicine, Division of Cardiac Anesthesia, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Robich MP; Department of Surgery, Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Aziz H; Department of Surgery, Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Kilic A; Department of Surgery, Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Lawton JS; Department of Surgery, Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Voegtline K; Biostatistics, Epidemiology, and Data Management Core, Johns Hopkins University, Baltimore, MD 21205, USA.
  • Olson S; Biostatistics, Epidemiology, and Data Management Core, Johns Hopkins University, Baltimore, MD 21205, USA.
  • Brown CH; Department of Anesthesiology and Critical Care Medicine, Division of Cardiac Anesthesia, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Lima JAC; Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Das S; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
  • Dodd-O JM; Department of Anesthesiology and Critical Care Medicine, Division of Cardiac Anesthesia, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
J Clin Med ; 13(12)2024 Jun 10.
Article en En | MEDLINE | ID: mdl-38929926
ABSTRACT

Objectives:

Risk assessment models for cardiac surgery do not distinguish between degrees of liver dysfunction. We have previously shown that preoperative liver stiffness is associated with hospital length of stay following cardiac surgery. The authors hypothesized that a liver stiffness measurement (LSM) ≥ 9.5 kPa would rule out a short hospital length of stay (LOS < 6 days) following isolated coronary artery bypass grafting (CABG) surgery.

Methods:

A prospective observational study of one hundred sixty-four adult patients undergoing non-emergent isolated CABG surgery at a single university hospital center. Preoperative liver stiffness measured by ultrasound elastography was obtained for each participant. Multivariate logistic regression models were used to assess the adjusted relationship between LSM and a short hospital stay.

Results:

We performed multivariate logistic regression models using short hospital LOS (<6 days) as the dependent variable. Independent variables included LSM (< 9.5 kPa, ≥ 9.5 kPa), age, sex, STS predicted morbidity and mortality, and baseline hemoglobin. After adjusting for included variables, LSM ≥ 9.5 kPa was associated with lower odds of early discharge as compared to LSM < 9.5 kPa (OR 0.22, 95% CI 0.06-0.84, p = 0.03). The ROC curve and resulting AUC of 0.76 (95% CI 0.68-0.83) suggest the final multivariate model provides good discriminatory performance when predicting early discharge.

Conclusions:

A preoperative LSM ≥ 9.5 kPa ruled out a short length of stay in nearly 80% of patients when compared to patients with a LSM < 9.5 kPa. Preoperative liver stiffness may be a useful metric to incorporate into preoperative risk stratification.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza