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. 2024 Feb 19:17:743-752.
doi: 10.2147/JMDH.S449614. eCollection 2024.

How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery?

Li-Chin Sung  1   2   3   4 , Chuen-Chau Chang  5   6   7 , Chun-Chieh Yeh  8   9 , Yih-Giun Cherng  5   10 , Ta-Liang Chen  5   7   11 , Chien-Chang Liao  5   6   7   12   13
Affiliations

How Long After Coronary Artery Bypass Surgery Can Patients Have Elective Safer Non-Cardiac Surgery?

Li-Chin Sung et al. J Multidiscip Healthc. .

Abstract

Objective: To evaluate the complications and mortality after noncardiac surgeries in patients who underwent previous coronary artery bypass grafting (CABG).

Methods: We used insurance data and identified patients aged ≥20 years undergoing noncardiac surgeries between 2010 and 2017 in Taiwan. Based on propensity-score matching, we selected an adequate number of patients with a previous history of CABG (within preoperative 24 months) and those who did not have a CABG history, and both groups had balanced baseline characteristics. The association of CABG with the risk of postoperative complications and mortality was estimated (odds ratio [OR] and 95% confidence interval [CI]) using multiple logistic regression analysis.

Results: The matching procedure generated 2327 matched pairs for analyses. CABG significantly increased the risks of 30-day in-hospital mortality (OR 2.28, 95% CI 1.36-3.84), postoperative pneumonia (OR 1.49, 95% CI 1.12-1.98), sepsis (OR 1.49, 95% CI 1.17-1.89), stroke (OR 1.53, 95% CI 1.17-1.99) and admission to the intensive care unit (OR, 1.75, 95% CI 1.50-2.05). The findings were generally consistent across most of the evaluated subgroups. A noncardiac surgery performed within 1 month after CABG was associated with the highest risk for adverse events, which declined over time.

Conclusion: Prior history of CABG was associated with postoperative pneumonia, sepsis, stroke, and mortality in patients undergoing noncardiac surgeries. Although we raised the possibility regarding deferral of non-critical elective noncardiac surgeries among patients had recent CABG when considering the risks, critical or emergency surgeries were not in the consideration of delay surgery, especially cancer surgery.

Keywords: adverse events; coronary artery bypass surgery; noncardiac surgeries; postoperative complications; postoperative mortality.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

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Grants and funding

This study was supported in part by the National Science and Technology Council, Taiwan (NSTC112-2314-B-038-141; MOST111-2320-B-532-001-MY3; MOST110-2314-B-038-108-MY2; MOST108-2320-B-038-070-MY3).

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