| Autor: |
Jeffrey M. Dodd-o, Wei Dong Gao, Nadia B. Hensley, Laeben Lester, Anubhav Kapoor, Sachdanand Hebbar, Brian Bush, Maria Bauer, Noah Rolleri, Brian C. Cho, Nauder Faraday, Thomas S. Metkus, Rosanne Sheinberg, Kimberly N. Hollander, Sarabdeep Singh, Domagoj Mladinov, Lee A. Goeddel, Jochen Steppan, Stephanie O. Ibekwe, Samhati Mondal, Stephanie Cha |
| Rok vydání: |
2021 |
| Předmět: |
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| Popis: |
Importance: Abnormal left ventricular (LV) diastolic function, with or without a diagnosis of heart failure, is a common finding that can be easily diagnosed by intra-operative transesophageal echocardiography (TEE). The association of diastolic function with duration of hospital stay after coronary artery bypass (CAB) is unknown. Objective: To determine if abnormal LV diastolic function (diastolic dysfunction) is associated with length of hospital stay after coronary artery bypass surgery (CAB). Design: Prospective observational studySetting: A single tertiary academic medical centerParticipants: Patients with normal systolic function undergoing isolated CAB from September 2017 through June 2018. Exposures: LV function during diastole, as assessed by intra-operative TEE prior to coronary revascularization. Main Outcomes and Measures: The primary outcome was duration of postoperative hospital stay. Secondary intermediate outcomes included common postoperative cardiac, respiratory, and renal complications. Results: The study included 176 participants (mean age 65.2 +/- 9.2 years, 73% male); 106 (60.2%) had LV diastolic dysfunction. Median time to hospital discharge was significantly longer for subjects with diastolic dysfunction (9.1/IQR 6.6-13.5 days) than those with normal LV diastolic function (6.5/IAR 5.3-9.7days) (P< 0.001). The probability of hospital discharge was 34% lower (HR 0.66/95% CI 0.47-0.93) for subjects with diastole dysfunction, independent of potential confounders, including a baseline diagnosis of heart failure. There was a dose-response relation between severity of diastolic dysfunction and probability of discharge. LV diastolic dysfunction was also associated with postoperative cardio-respiratory complications; however, these complications did not fully account for the relation between LV diastolic dysfunction and prolonged length of hospital stay.Conclusions and Relevance: In patients with normal systolic function undergoing CAB, diastolic dysfunction is associated with prolonged duration of postoperative hospital stay. This association cannot be explained by baseline comorbidities or common post-operative complications. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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