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Impact of Intubation Time on Survival following Coronary Artery Bypass Grafting: Insights from the Surgical Treatment for Ischemic Heart Failure (STICH) Trial.

Publication ,  Journal Article
Bouabdallaoui, N; Stevens, SR; Doenst, T; Wrobel, K; Bouchard, D; Deja, MA; Michler, RE; Chua, YL; Kalil, RAK; Selzman, CH; Daly, RC; Sun, B ...
Published in: J Cardiothorac Vasc Anesth
June 2018

OBJECTIVE: The authors aimed to assess determinants of intubation time and evaluate its impact on 30-day and 1-year postoperative survival in Surgical Treatment for Ischemic Heart Failure (STICH) trial patients. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: A multivariable Cox proportional hazards model was used among the 1,446 surgical patients from the STICH trial who survived 36 hours after operation, in order to identify perioperative factors associated with 30-day and 1-year postoperative mortality. A multivariable logistic regression model was used to determine risk factors associated with intubation time. MEASUREMENTS AND MAIN RESULTS: At 36 hours post-operation, 1,298 (out of 1,446) were extubated and 148 (10.2%) still intubated. Median postoperative intubation time was 11.4 hours. Among patients surviving 36 hours, a multivariable model was developed to predict 30-day (c-index = 0.88) and 1-year (c-index = 0.78) mortality. Intubation time was the strongest independent predictor of 30-day (hazard ratio [HR] 5.50) and 1-year mortality (HR 3.69). Predictors of intubation time >36 hours included mitral valve procedure, New York Heart Association class, left ventricular systolic volume index, creatinine, previous coronary artery bypass grafting (CABG), and age. Results were similar in patients surviving 24 hours post-operation, where intubation time was also the strongest predictor of 30-day (HR 4.18, c-index 0.87) and 1-year (HR 2.81, c-index 0.78) mortality. CONCLUSIONS: Intubation time is the strongest predictor of 30-day and 1-year mortality among patients with ischemic heart failure undergoing CABG. Combining intubation time with other mortality risk factors may allow the identification of patients at the highest risk for whom the development of specific strategies may improve outcomes.

Duke Scholars

Published In

J Cardiothorac Vasc Anesth

DOI

EISSN

1532-8422

Publication Date

June 2018

Volume

32

Issue

3

Start / End Page

1256 / 1263

Location

United States

Related Subject Headings

  • Time Factors
  • Proportional Hazards Models
  • Myocardial Ischemia
  • Male
  • Logistic Models
  • Intubation, Intratracheal
  • Humans
  • Heart Failure
  • Female
  • Coronary Artery Bypass
 

Citation

APA
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ICMJE
MLA
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Bouabdallaoui, N., Stevens, S. R., Doenst, T., Wrobel, K., Bouchard, D., Deja, M. A., … STICH Trial Investigators, . (2018). Impact of Intubation Time on Survival following Coronary Artery Bypass Grafting: Insights from the Surgical Treatment for Ischemic Heart Failure (STICH) Trial. J Cardiothorac Vasc Anesth, 32(3), 1256–1263. https://doi.org/10.1053/j.jvca.2017.12.038
Bouabdallaoui, Nadia, Susanna R. Stevens, Torsten Doenst, Krzysztof Wrobel, Denis Bouchard, Marek A. Deja, Robert E. Michler, et al. “Impact of Intubation Time on Survival following Coronary Artery Bypass Grafting: Insights from the Surgical Treatment for Ischemic Heart Failure (STICH) Trial.J Cardiothorac Vasc Anesth 32, no. 3 (June 2018): 1256–63. https://doi.org/10.1053/j.jvca.2017.12.038.
Bouabdallaoui N, Stevens SR, Doenst T, Wrobel K, Bouchard D, Deja MA, et al. Impact of Intubation Time on Survival following Coronary Artery Bypass Grafting: Insights from the Surgical Treatment for Ischemic Heart Failure (STICH) Trial. J Cardiothorac Vasc Anesth. 2018 Jun;32(3):1256–63.
Bouabdallaoui, Nadia, et al. “Impact of Intubation Time on Survival following Coronary Artery Bypass Grafting: Insights from the Surgical Treatment for Ischemic Heart Failure (STICH) Trial.J Cardiothorac Vasc Anesth, vol. 32, no. 3, June 2018, pp. 1256–63. Pubmed, doi:10.1053/j.jvca.2017.12.038.
Bouabdallaoui N, Stevens SR, Doenst T, Wrobel K, Bouchard D, Deja MA, Michler RE, Chua YL, Kalil RAK, Selzman CH, Daly RC, Sun B, Djokovic LT, Sopko G, Velazquez EJ, Rouleau JL, Lee KL, Al-Khalidi HR, STICH Trial Investigators. Impact of Intubation Time on Survival following Coronary Artery Bypass Grafting: Insights from the Surgical Treatment for Ischemic Heart Failure (STICH) Trial. J Cardiothorac Vasc Anesth. 2018 Jun;32(3):1256–1263.
Journal cover image

Published In

J Cardiothorac Vasc Anesth

DOI

EISSN

1532-8422

Publication Date

June 2018

Volume

32

Issue

3

Start / End Page

1256 / 1263

Location

United States

Related Subject Headings

  • Time Factors
  • Proportional Hazards Models
  • Myocardial Ischemia
  • Male
  • Logistic Models
  • Intubation, Intratracheal
  • Humans
  • Heart Failure
  • Female
  • Coronary Artery Bypass