Factors Associated With Postoperative Complications Among Critical Patients Undergoing Open-Heart Surgery: A Cross-Sectional Study.
Arunee Kamhor, Thitipong Tankumpuan, Napaporn Wanitkun and 1 others
PMID 40440179WHAT IT FOUND
After open-heart surgery, frailty, packed red cells, vasopressor/inotrope doses and operative risk were linked to more severe 24-hour complications in 192 patients.
Kidney function, inflammation and central venous pressure did not show this link in the final model.
Key findings
01In the final regression model, frailty, amount of packed red cells transfused, vasopressors and inotropes and operative risk were linked to more severe postoperative complications.
02In the final regression model, kidney function, central venous pressure and inflammation were not linked to complication severity within the first 24 hours.
03After adjusting for age, sex, education and BMI, a one-unit rise in frailty was linked to 5.20 more points on the 0 to 100 complication severity index.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it shows associations, not that any factor caused complications. It was done at a university hospital in Bangkok and included only elective first-time open-heart surgery, so it may not apply to other settings, urgent surgery or heart transplant. Comorbidities were not controlled for, even though hypertension, diabetes, hyperlipidemia, chronic kidney disease and other conditions were common. Central venous pressure was measured only once after ICU admission, while the authors note that circulation can change rapidly after open-heart surgery. Packed red cell transfusion and vasopressor or inotrope doses may reflect how sick patients already were, rather than independently causing complications. Only patients with normal cognitive screening were included, so the findings do not cover patients with cognitive impairment.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that reducing packed red cell transfusion, vasopressor or inotrope doses, or operative risk will prevent complications. This study measured associations after surgery and could not show cause.