Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Risk factors associated with fast-track after open heart surgery

Authors: Rybka М.М., Diasamidze К.E., Yudin G.V., Goncharov A.A., Chitorelidze М.А., Mishin G.М.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2024-21-4-354-368

UDC: 616.12-089.168.1-06

Link: Clinical Physiology of Blood Circulaiton. 2024; 21 (4): 354-368

Quote as: Rybka М.М., Diasamidze К.E., Yudin G.V., Goncharov A.A., Chitorelidze М.А., Mishin G.М. Risk factors associated with fast-track after open heart surgery. Clinical Physiology of Circulation. 2024; 21 (4): 354–368 (in Russ.). DOI: 10.24022/1814-6910-2024-21-4-354-368

Received / Accepted:  18.11.2024 / 03.12.2024

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Abstract

Objective. To identify perioperative risk factors associated with fast-track (FT) cardiac surgery.

Material and methods. Retrospective cohort study. Surgical treatment of 820 (321 (39.1%) women and 499 (60.9%) men) patients aged 18 to 84 years who underwent heart surgery in 2019 was analyzed. Anamnestic data, preoperative results of laboratory and instrumental studies, intraoperative data, laboratory and instrumental and clinical data of the early postoperative period were taken from the electronic database. A total of 96 parameters were analyzed. The incidence of FT in the study cohort was 17.2% [95% CI 14.8; 19.9].

Results. As a result of multivariate binary logistic regression analysis, 3 models were created (characterizing the pre-, intra- and postoperative periods). Each model was characterized by high prognostic accuracy, sensitivity and specificity both on the test data set and on the data set for internal validation. Independent risk factors associated with the duration of mechanical ventilation and fast-track were identified. For each factor, a regression coefficient was calculated to predict FT.

Conclusion. The study of risk factors allowed for a personalized approach to each patient, determining their individual risk and the possibility of fast-track.

References

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  1. Wong W.T., Lai V.K., Chee Y.E., Lee A. Fast-track cardiac care for adult cardiac surgical patients. Cochrane Database Syst Rev. 2016; 9 (9): CD003587. DOI: 10.1002/14651858.CD003587
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  3. Tiganila R., McCoy C., Gilbert R., Raco J. The safety of immediate extubation, and factors associated with delayed extubation, in cardiac surgical patients receiving fast-track cardiac anesthesia: an integrative review. Can. J. Respir. Ther. 2023; 59: 8–19. DOI: 10.29390/cjrt-2022-037
  4. Diasamidze K.E., Yalieva L.K., Mishin G.M., Chitorelidze M.A. Evolution of fast-track strategy: development, management, and looking ahead. Part 1. Clinical Physiology of Circulation. 2022; 19 (3): 211–220 (in Russ.). DOI: 10.24022/1814-6910-2022-19-3-211-220
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  17. Rodriguez-Blanco Y.F., Carvalho E.M., Gologorsky A., Lo K., Salerno T.A., Gologorsky E. Factors associated with safe extubation in the operating room after on-pump cardiac valve surgery. J. Card. Surg. 2016; 31 (5): 274–281. DOI: 10.1111/jocs.12736
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About Authors

  • Mikhail M. Rybka, Dr. Med. Sci., Deputy Director for Anesthesiology and Resuscitation, Head of the Department of Anesthesiology, Resuscitation and Intensive Care; ORCID
  • Kakhaber E. Diasamidze, Dr. Med. Sci., Leading Researcher; ORCID
  • Genadiy V. Yudin, Dr. Med. Sci., Head of Intensive Care Unit No. 3; ORCID
  • Andrey A. Goncharov, Cand. Med. Sci., Anesthesiologist; ORCID
  • Mariam A. Chitorelidze, Postgraduate; ORCID
  • Georgiy M. Mishin, Postgraduate; ORCID

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