Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2020; 12(10): 492-500
Published online Oct 26, 2020. doi: 10.4330/wjc.v12.i10.492
Risk score for predicting abdominal complications after coronary artery bypass grafting
Dmitry Vladimirovich Belov, Dmitry Victorovich Garbuzenko, Ksenia Alekseevna Abramovskikh, Nikolay Olegovich Arefyev
Dmitry Vladimirovich Belov, Department of Hospital Surgery, Federal Center of Cardiovascular Surgery of the Ministry of Health of Russia (the city of Chelyabinsk), Chelyabinsk 454003, Russia
Dmitry Victorovich Garbuzenko, Department of Faculty Surgery, South Ural State Medical University, Chelyabinsk 454092, Russia
Ksenia Alekseevna Abramovskikh, Department of Hospital Surgery, South Ural State Medical University, Chelyabinsk 454092, Russia
Nikolay Olegovich Arefyev, Department of Pathological Anatomy and Forensic Medicine, South Ural State Medical University, Chelyabinsk 454092, Russia
Author contributions: Belov DV wrote the manuscript and performed data analysis; Garbuzenko DV contributed to the conception and design of the study, acquisition, analysis and interpretation of data, and wrote the manuscript; Abramovskikh KA contributed to writing the manuscript, drafting the conception and design of the study; Arefyev NO contributed to analysis of data, and wrote and revised the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Federal Center of Cardiovascular Surgery of the Ministry of Health of Russia (the city of Chelyabinsk).
Informed consent statement: Each “Patient's Medical Record” contained an “Informed voluntary consent to the processing of personal data” filled out and signed by the patient, where the patient gave permission to use his/her personal data for conducting scientific research.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Nikolay Olegovich Arefyev, MD, Academic Researcher, Surgeon, Department of Pathological Anatomy and Forensic Medicine, South Ural State Medical University, Vorovskogo, 64, Chelyabinsk 454092, Russia. nikolai.arefyev@gmail.com
Received: November 26, 2019
Peer-review started: November 26, 2019
First decision: March 18, 2020
Revised: June 8, 2020
Accepted: August 25, 2020
Article in press: August 25, 2020
Published online: October 26, 2020
Processing time: 331 Days and 12.3 Hours
Abstract
BACKGROUND

Although early abdominal complications after coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) are rare, the associated mortality remains high.

AIM

To develop a risk score for the prediction of early abdominal complications after CABG with CPB.

METHODS

This retrospective study was performed in the Federal State Budgetary Establishment “Federal Center of Cardiovascular Surgery” of the Ministry of Health of Russia (the city of Chelyabinsk) and included data of 6586 patients who underwent CABG with CPB during 2011-2017. The risk factors taken for evaluation were compared between patients with early abdominal complications (n = 73) and without them (n = 6513). We identified the most important risk factors and their influence on the development of early abdominal complications after CABG with CPB.

RESULTS

Gender and the presence of postinfarction cardiosclerosis, chronic kidney disease, or diabetes in the anamnesis did not affect the occurrence of abdominal complications. The leading risk factors of the early abdominal complications after CABG with CPB were multifocal atherosclerosis, extracorporeal membrane oxygenation, intra-aortic balloon pump, atrial fibrillation, perioperative myocardial infarction, and the need for resternotomy in the postoperative period. The average value of the predicted probability was 0.087 ± 0.015 in patients with early abdominal complications after CABG with CPB and 0.0094 ± 0.0003 in patients without these complications. The percentage of correct classification turned out to be 98.9%. After calculating a score for each of the leading risk factors, we counted a total score for each particular patient. The highest risk was noted in patients with a total score of 7 or more.

CONCLUSION

The developed score predicts the risk of early abdominal complications after CABG with CPB and makes it possible to stratify patients by risk groups.

Keywords: Coronary artery bypass grafting; Cardiopulmonary bypass; Abdominal complications; Risk factors; Risk score

Core Tip: Although early abdominal complications after coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) are rare, the associated mortality remains high. We developed a score for the prediction of early abdominal complications after CABG with CPB. The leading risk factors were multifocal atherosclerosis, extracorporeal membrane oxygenation, intra-aortic balloon pump, atrial fibrillation, perioperative myocardial infarction, and the need for resternotomy in the postoperative period. A risk score that involves these factors makes it possible to stratify patients, which is important for timely treatment and diagnosis and, ultimately, will help to reduce postoperative mortality.