Accepted for/Published in: Interactive Journal of Medical Research
Date Submitted: Jan 20, 2023
Open Peer Review Period: Jan 20, 2023 - Feb 7, 2023
Date Accepted: Feb 21, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Body Surface Area Weighted Left Ventricular End-diastolic Diameter More Accurately Predicts Male CABG Outcomes
ABSTRACT
Background:
High left ventricular end-diastolic diameter (LVEDD) results in worse outcomes in coronary artery bypass grafting (CABG) while referring left ventricular (LV) size and volume measurements to body surface area (BSA) should improve predictability.
Objective:
We propose that BSA weighted LVEDD (bLVEDD) is a more reliable outcome predictor in CABG than only LVEDD.
Methods:
This study was a multi-center retrospective analysis of observational data. Patients admitted between October 2016 and May 2021, were included. All patients were elective surgery patients, and emergency surgery patients were excluded. All subjects were treated with standard care and the clinical data were obtained via the institutional registry following the Society of Thoracic Surgeons National Adult Cardiac Database. The bLVEDD was defined as LVEDD divided by BSA. The primary outcome was in-hospital all-cause mortality (30-day) and the secondary outcomes were postoperative severe adverse events.
Results:
In total, 9,474 patients from five centers under the Chinese Cardiac Surgery Registry were eligible for analysis. A high LVEDD was a negative factor for male patients’ mortality (OR 1.44, P < 0.01) and secondary outcomes. For female patients, the LVEDD was associated with secondary outcomes but did not reach statistical differences for morality. The bLVEDD showed a strong association with post-surgery mortality (OR 2.70, P < 0.01), and secondary outcomes changed in parallel together with bLVEDD in male patients. However, bLVEDD did not reach statistical differences when fitting neither mortality nor severer outcomes in female patients. In male patients, the categorical bLVEDD showed high power to predict mortality (AUC 0.71, P < 0.01), while BSA (AUC 0.62) and LVEDD (AUC 0.64) both contributed to the risk of mortality but were not as significant as the bLVEDD (P <0.01).
Conclusions:
The bLVEDD is an important predictor for male mortality in CABG, removing the bias of BSA and showing a robust ability to fitting mortality.
Citation
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