Precursor Events in Cardiac Surgery: Are they Associated with Post-operative Outcomes?

Abstract

Background: The purpose of this study is to determine whether precursor events are associated with a post-operative composite outcome in a low-medium risk cardiac surgical population. These precursor events may be promising targets for strategies aimed at quality improvement. Methods: This study was a case control design where the outcome of major adverse events (MACE) was assessed in patients exposed to four intra-operative precursor events. Cases and controls were matched 1:1 using propensity score matching, Univariate comparison of ?1 precursor event in the matched groups was performed. Results: The primary outcome of ?1 precursor event occurred significantly more frequently in the MACE patient group vs the non-MACE patients group (33% vs. 24%; p=0.015). The individual events of bleeding and difficulty weaning from CPB were significantly higher in the MACE group whereas incomplete revascularization/repair and repair/regrafting were not. Conclusion: Quality improvement techniques aimed at mitigating the consequences of precursor events may improve surgical outcomes for these patients.