Table 2.
Multivariable Models of 5-y Mortality, Hospital Length of Stay (HLOS), and Ventricular Dysfunction
| Model variables | Mortality |
Hospital length of stay |
Ventricular dysfunction |
|||
|---|---|---|---|---|---|---|
| HR (95% CI) | P | HR (95% CI) | P | OR (95% CI) | P | |
| Age (years in deciles) | 1.62 (1.25–2.09) | 0.0002 | 1.12 (1.06–1.19) | <0.0001 | 1.13 (0.93–1.38) | 0.189 |
| Gender (female) | 0.48 (0.24–0.96) | 0.0376 | 1.29 (1.09–1.51) | 0.0023 | 0.60 (0.33–1.03) | 0.0747 |
| Institution 1 | 0.77 (0.39–1.49) | 0.4475 | 0.62 (0.53–0.72) | <0.0001 | 0.53 (0.32–0.90) | 0.0189 |
| Caucasian race | 1.62 (0.68–3.83) | 0.2695 | 1.21 (1.02–1.43) | 0.0225 | 1.49 (0.84–2.73) | 0.1802 |
| Preoperative LVEF (%) | 0.97 (0.95–0.99) | 0.0014 | 0.99 (0.99–1) | 0.0716 | 0.94 (0.92–0.95) | <0.0001 |
| Hematocrit | 0.92 (0.88–0.97) | 0.0053 | 0.99 (0.97–1.00) | 0.2363 | 0.94 (0.90–0.98) | 0.0085 |
| CPB duration | 0.99 (0.98–1) | 0.0601 | 1.00 (1.00–1.00) | 0.0065 | 1.00 (1.00–1.01) | 0.0003 |
| Time of day surgery began | 1.02 (0.94–1.10) | 0.636 | 0.98 (0.96–1.00) | 0.0622 | 0.94 (0.79–1.02) | 0.1094 |
| Highest postoperative creatinine | 5.20 (3.22–8.40) | <0.0001 | 1.38 (1.14–1.73) | 0.0017 | ||
| Preoperative digoxin | 2.37 (1.07–5.26) | 0.0331 | ||||
| Hypertension | 0.63 (0.39–1.04) | 0.0746 | ||||
| HMG-CoA reductase inhibitor | 0.58 (0.36–0.94) | 0.0271 | ||||
| BMI | 1.00 (0.99–1.01) | 0.1056 | ||||
| Postoperative new AF | 1.83 (1.60–2.09) | <0.0001 | ||||
| Postoperative inotrope | 1.46 (1.33–1.59) | <0.0001 | ||||
| Preoperative ACEI | 1.67 (1.13–2.49) | 0.0101 | ||||
| MI within 2 wk | 1.82 (1.18–2.77) | 0.0057 | ||||
| Preoperative diuretic | 1.45 (0.94–2.21) | 0.0835 | ||||
| Biomarkers added individually to above clinical models | ||||||
| hFABP | ||||||
| Post CPB | 1.00 (0.99–1.01) | 0.5244 | 1.00 (1.00–1.00) | 0.4083 | 1.00 (1.00–1.01) | 0.2298 |
| POD1 | 1.01 (1.01–1.02) | <0.0001 | 1.00 (1.00–1.00) | 0.0004 | 1.01 (1.01–1.01) | <0.0001 |
| Peak | 1.01 (1.01–1.01) | <0.0001 | 1.00 (1.00–1.00) | 0.0309 | 1.01 (1.01–1.01) | <0.0001 |
| cTnI | ||||||
| POD1 | 1.03 (1.01–1.04) | 0.0077 | 0.99 (0.98–1.00) | 0.0039 | 1.03 (1.01–1.05) | 0.0072 |
| Peak | 1.03 (1.01–1.05) | 0.0062 | 0.99 (0.98–1.00) | 0.0047 | 1.03 (1.01–1.05) | 0.0024 |
| Myoglobin | ||||||
| POD1 | 1.00 (1.00–1.00) | 0.0544 | 1.00 (1.00–1.00) | 0.0002 | 1.00 (1.00–1.00) | 0.2133 |
| Peak | 1.00 (1.00–1.00) | 0.019 | 1.00 (1.00–1.00) | <0.0001 | 1.00 (1.00–1.00) | 0.0341 |
| CKMB | ||||||
| POD1 | 1.01 (1.00–1.01) | 0.06 | 1.00 (1.00–1.00) | 0.0044 | 1.00 (1.00–1.01) | 0.2179 |
| Peak | 1.01 (1.00–1.01) | 0.0614 | 1.00 (1.00–1.00) | 0.0008 | 1.00 (1.00–1.01) | 0.3627 |
All demographic and clinical variables (excluding biomarkers) shown in model columns are included in the analyses. Mortality and HLOS were modeled as Cox proportional hazard models, ventricular dysfunction as a nominal logistic regression model. Biomarkers were added individually and independently and adjusted for their respective preoperative values. Hospital length of stay is a continuous outcome measured in days.
P values are expressed using Wald test.
HR = hazard ratio; OR = odds ratio; CI = confidence interval; MI = myocardial infarction; BMI = body mass index; LVEF = left ventricular ejection fraction; AF = atrial fibrillation; HMG = 3-hydroxy-3-methyl-glutaryl-CoA reductase; ACE = angiotensin converting enzyme; CPB = cardiopulmonary bypass; Post = post-CPB; POD = postoperative day; hFABP = heart-type fatty acid binding protein; cTnI = cardiac troponin I; CKMB = creatinine kinase MB fraction.