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Cited by 286Cardiac and Coronary Surgery TechniquesMechanical Circulatory Support DevicesCardiac, Anesthesia and Surgical Outcomes

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Predictors of low cardiac output syndrome after coronary artery bypass

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Rao, Vivek, Ivanov, Joan, Weisel, Richard D., Ikonomidis, John S., Christakis, George T., David, Tirone E.·1996·The Journal of Thoracic and Cardiovascular Surgery
DOI 10.1016/s0022-5223(96)70176-9
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Abstract

The purpose of this study was to identify patients at risk for the development of low cardiac output syndrome after coronary artery bypass. Low cardiac output syndrome was defined as the need for postoperative intraaortic balloon pump or inotropic support for longer than 30 minutes in the intensive care unit to maintain the systolic blood pressure greater than 90 mm Hg and the cardiac index greater than 2.2 L/min per square meter. The preoperative patient characteristics that were independent predictors of low cardiac output syndrome were identified among 4558 consecutive patients who underwent isolated coronary artery bypass at The Toronto Hospital between July 1, 1990, and December 31, 1993. The overall prevalence of low cardiac output syndrome was 9.1% (n = 412). The operative mortality rate was higher in patients in whom low cardiac output syndrome developed than in those in whom it did not develop (16.9% versus 0.9%, p < 0.001). Stepwise logistic regression analyses identified nine independent predictors of low output syndrome (percent frequency in parentheses) and calculated the factor-adjusted odds ratios associated with each predictor: (1) left ventricular ejection fraction less than 20% (27%, odds ratio 5.7); (2) repeat operation (25%, odds ratio 4.4); (3) emergency operation (27%, odds ratio 3.7); (4) female gender (16%, odds ratio 2.5); (5) diabetes (13%, odds ratio 1.6); (6) age older than 70 years (13%, odds ratio 1.5); (7) left main coronary artery stenosis (12%, odds ratio 1.4); (8) recent myocardial infarction (16%, odds ratio 1.4); and (9) triple-vessel disease (10%, odds ratio 1.3). Low cardiac output syndrome is a clinical outcome that may result from inadequate myocardial protection or perioperative ischemic injury. Patients at high risk for the development of low cardiac output syndrome should be the focus of trials of new techniques of myocardial protection to resuscitate the ischemic myocardium.

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Research works printed but not linked: 1

  1. Christakis, 1989, The changing pattern of coronary bypass surgery, Circulation, 80, I151

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Metadata

Authors
Rao, V., Ivanov, J., Weisel, R. D., Ikonomidis, J. S., Christakis, G. T., & David, T. E.
Affiliations
University of Toronto (CA)
ORCID
Venue
The Journal of Thoracic and Cardiovascular Surgery
Publisher
Elsevier BV
Published
1996-07
Volume
112
Issue
1
Pages
38-51
ISSN
0022-5223 (ISSN-L)
DOI
10.1016/s0022-5223(96)70176-9
OpenAlex
W2072841444
Cited by
286
References
32
Citations by year
2026: 4 · 2025: 7 · 2024: 6 · 2023: 14 · 2022: 6 · 2021: 9 · 2020: 15 · 2019: 7 · 2018: 11 · 2017: 9 · 2016: 10 · 2015: 7 · 2014: 12 · 2013: 9 · 2012: 17
FWCI
5.41
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Heart and Stroke Foundation of Canada
  • Medical Research Council Canada
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Mechanical Circulatory Support Devices
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Keywords
low cardiac output syndrome, coronary artery bypass grafting, risk factors, left ventricular ejection fraction, reoperation, emergency surgery, female sex, diabetes mellitus, old age, left main coronary artery stenosis, recent myocardial infarction, three-vessel coronary artery disease, postoperative mortality, cardioprotection, perioperative myocardial ischemia, intra-aortic balloon pump, inotropic support
MeSH terms
Aged, Coronary Artery Bypass, Cardiac Output, Low, Female, Humans, Male, Middle Aged, Postoperative Complications, Prognosis, Prospective Studies, Sex Factors, Syndrome, Survival Rate, Odds Ratio, Ventricular Dysfunction, Left, Diabetes Complications

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