Abstract
BackgroundHyperbilirubinemia is a common complication after off-pump coronary artery bypass grafting (OPCAB), but the incidence and the risk factors are unclear. This study aimed to analyze the incidence and risk factors of postoperative hyperbilirubinemia in patients undergoing OPCAB.MethodsFrom December 2016 to March 2019, a total of 416 consecutive patients undergoing OPCAB were enrolled in this single-center retrospective study. Patients were divided into the normal serum total bilirubin group and the hyperbilirubinemia group based on the serum total bilirubin levels. Perioperative variables between the two groups were compared by univariate logistic regression analysis. Then, multivariate binary logistic regression analysis was used to analyze the independent risk factors of developing hyperbilirubinemia in patients underwent OPCAB. P < 0.05 was considered as statistically significant.ResultsThirty two of 416 (7.7%) patients developed postoperative hyperbilirubinemia. Univariate regression analysis showed significant differences in gender (73.96% vs. 93.75%, P = 0.012), preoperative total bilirubin levels (11.92 ± 4.52 vs. 18.28 ± 7.57, P < 0.001), perioperative IABP implantation (22.66% vs. 43.75%, P = 0.008), perioperative blood transfusion (37.50% vs. 56.25%, P = 0.037) between the two groups. Multivariate logistic regression analysis revealed that elevated preoperative serum total bilirubin levels (OR = 1.225, 95% CI 1.145–1.310, P < 0.001), perioperative blood transfusion (OR = 4.488, 95% CI 1.876–10.737, P = 0.001) and perioperative IABP implantation (OR = 4.016, 95% CI 1.709–9.439, P = 0.001) were independent risk factors for hyperbilirubinemia after OPCAB.ConclusionsHyperbilirubinemia is also a common complication after OPCAB. Elevated preoperative serum total bilirubin levels, perioperative blood transfusion, and perioperative IABP implantation were independent risk factors for patients developing hyperbilirubinemia after OPCAB. Further studies need to be conducted to confirm the risk factors of hyperbilirubinemia after OPCAB procedure.
Highlights
Hyperbilirubinemia is a common complication after off-pump coronary artery bypass grafting (OPCAB), but the incidence and the risk factors are unclear
Hyperbilirubinemia is a severe complication after OPCAB, and is associated with increased postoperative morbidity and mortality, ranging from 4.1 to 25%, due to the differences of demographic characteristics, surgery sites and techniques, cardiopulmonary
Mastoraki et al and Sharma et al have reported the hyperbilirubinemia after cardiac surgery, but they did not distinguish the surgical types, use of Cardiopulmonary bypass (CPB) and other factors [2, 3]
Summary
Hyperbilirubinemia is a common complication after off-pump coronary artery bypass grafting (OPCAB), but the incidence and the risk factors are unclear. This study aimed to analyze the incidence and risk factors of postoperative hyperbilirubinemia in patients undergoing OPCAB. Off-pump coronary artery bypass grafting (OPCAB) has been accepted by more and more cardiac surgeons due to its less neurological complications and lower in-hospital mortality [1]. Hyperbilirubinemia is a severe complication after OPCAB, and is associated with increased postoperative morbidity and mortality, ranging from 4.1 to 25%, due to the differences of demographic characteristics, surgery sites and techniques, cardiopulmonary. Studies on the incidence and risk factor analysis of hyperbilirubinemia after OPCAB are still limited
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