Hepatic and Renal Outcomes in Systemic Lupus Erythematosus Patients following Coronary Artery Bypass Grafting: A Study from the National Inpatient Sample

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiac Surgery Pub Date : 2023-12-09 DOI:10.1155/2023/8846398

Krishnah G. Bellam, Sharif A. Sabe, Nicholas R. Huang, Nishanth Chalasani, Dwight Douglas Harris, Noah Feldman, Phillip R. Schmitt, Anthony Harwell, Frank W. Sellke, Afshin Ehsan

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引用次数: 0

Abstract

Background and Aim of the Study. While several studies have suggested a relationship between adverse postoperative outcomes and systemic lupus erythematosus (SLE) in major surgical settings, no study to date has explored postoperative outcomes of SLE patients undergoing coronary artery bypass grafting (CABG). This study aimed to compare the characteristics and outcomes of SLE patients compared to non-SLE patients undergoing CABG. Methods. We utilized the Nationwide Inpatient Sample (NIS) data from 2008–2018 for CABG patients ≥18 years old. Patients were divided into two groups based on SLE status (confirmed SLE diagnosis or no SLE present). Primary outcomes were in-hospital mortality, favorable discharge, and length of stay (LOS). Secondary outcomes included acute kidney injury (AKI), acute liver injury (ALI), hemodialysis, acute myocardial infarction (AMI), and cardiogenic shock. Patient characteristics including age, sex, race, and preexisting comorbidities were considered. Multivariable models, adjusting for confounding variables, were utilized. Results. Data from a total of 352,772 patients who underwent CABG were analyzed. 980 patients had a diagnosis code for SLE. SLE and non-SLE patients had similar rates of in-hospital mortality (OR = 0.92, [0.63–1.35]), nonhome discharge (OR = 1.09, [0.95–1.24]), and LOS (OR = 1.02, [0.99–1.06]). SLE patients developed AKI at a higher rate (OR = 1.50, [1.05–1.48]) and ALI at a lower rate (OR = 0.35, [0.16–0.74]). Both groups had similar rates of hemodialysis (OR = 1.19, [0.98–1.44]), AMI (OR = 0.93, [0.81–1.06]), and cardiogenic shock (OR = 0.8, [0.61–1.05]). Conclusion. These findings suggest that SLE patients undergoing CABG have similar mortality, discharge disposition, and LOS compared to non-SLE patients. However, SLE patients are at increased risk of AKI and decreased risk of ALI than non-SLE patients. These associations warrant further investigation to elucidate their physiologic basis.

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冠状动脉旁路移植术后系统性红斑狼疮患者的肝脏和肾脏预后：一项来自全国住院患者样本的研究

研究背景和目的。虽然有几项研究表明，在大手术环境中，不良的术后结果与系统性红斑狼疮(SLE)之间存在关系，但迄今为止还没有研究探讨SLE患者接受冠状动脉旁路移植术(CABG)的术后结果。本研究旨在比较SLE患者与非SLE患者行CABG的特点和结果。方法。我们使用了2008-2018年全国住院患者样本(NIS)数据，用于≥18岁的CABG患者。根据SLE状态(确诊SLE或无SLE)将患者分为两组。主要结局为住院死亡率、良好出院和住院时间(LOS)。次要结局包括急性肾损伤(AKI)、急性肝损伤(ALI)、血液透析、急性心肌梗死(AMI)和心源性休克。患者的特征包括年龄、性别、种族和先前存在的合并症。采用多变量模型，对混杂变量进行调整。结果。共分析了352,772例接受CABG的患者的数据。980例患者有SLE诊断代码。SLE和非SLE患者的住院死亡率(OR = 0.92，[0.63-1.35])、非家庭出院率(OR = 1.09，[0.95-1.24])和LOS (OR = 1.02，[0.99-1.06])相似。SLE患者发生AKI的比率较高(OR = 1.50，[1.05-1.48])，而发生ALI的比率较低(OR = 0.35，[0.16-0.74])。两组血液透析(OR = 1.19，[0.98-1.44])、AMI (OR = 0.93，[0.81-1.06])、心源性休克(OR = 0.8，[0.61-1.05])发生率相似。结论。这些发现表明，与非SLE患者相比，接受CABG的SLE患者具有相似的死亡率、出院处置和LOS。然而，与非SLE患者相比，SLE患者AKI风险增加，ALI风险降低。这些关联值得进一步研究以阐明其生理基础。

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来源期刊

Journal of Cardiac Surgery 医学-外科

CiteScore

2.90

自引率

12.50%

发文量

976

审稿时长

3-8 weeks

期刊介绍： Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.