Intraoperative myocardial acidosis as a risk for hospital readmission after cardiac surgery

Dharam J. Kumbhani, Nancy A. Healey, Hemant S. Thatte, Vladimir Birjiniuk, Michael D. Crittenden, Patrick R. Treanor, Shukri F. Khuri

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: This study elucidates the relationship between intraoperative myocardial acidosis/ischemia and the risk of unplanned hospital readmissions within 30 days and 6 months after cardiac surgery. Methods: Myocardial tissue pH (corrected to 37°C: pH37C) was monitored in 221 patients during cardiac surgery. Regional myocardial acidosis was defined in terms of specific pH thresholds. Results: Fourteen percent and 27% of the patients were readmitted within 30 days and 6 months postoperatively, respectively. The mean number of readmissions was 1.67 ± 1.24; pH37C <6.85 at the end of cardiopulmonary bypass (CPB) was identified as the threshold most significantly associated with readmission. This threshold was associated with a 6-fold increased risk of readmission within 30 days and a 5-fold increased risk within 6 months. Conclusions: Persistent regional myocardial acidosis after weaning from CPB independently determines unplanned readmission rates up to 6 months postoperatively. This study underscores the importance of avoiding myocardial tissue acidosis during cardiac surgery.

Original languageEnglish (US)
Pages (from-to)373-380
Number of pages8
JournalAmerican journal of surgery
Volume198
Issue number3
DOIs
StatePublished - Sep 1 2009

Keywords

  • Cardiopulmonary bypass
  • Coronary artery bypass graft surgery
  • Ischemia
  • Myocardial protection
  • Outcomes
  • Reperfusion

ASJC Scopus subject areas

  • Surgery

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    Kumbhani, D. J., Healey, N. A., Thatte, H. S., Birjiniuk, V., Crittenden, M. D., Treanor, P. R., & Khuri, S. F. (2009). Intraoperative myocardial acidosis as a risk for hospital readmission after cardiac surgery. American journal of surgery, 198(3), 373-380. https://doi.org/10.1016/j.amjsurg.2009.01.013