Table 3:
Mortality and gastrointestinal bleeding outcomes in pre-specified subgroups
| CSICU subgroup | In-hospital death by 90 days |
Clinically important upper gastrointestinal bleeding |
|||||||
|---|---|---|---|---|---|---|---|---|---|
| ITT, n | PPI (n = 823), n (%) | H2RB (n = 805), n (%) | PPI versus H2RB, OR (95% CI)a | P-Value for interactiona | PPI (n = 823), n (%) | H2RB (n = 805), n (%) | PPI versus H2RB, OR (95% CI)a | P-Value for interactiona | |
| Type of surgery | 0.250 | 0.867 | |||||||
| MCS | 66 | 3 (0.4) | 1 (0.1) | 0.23 (0.02–2.38) | 2 (0.2) | 4 (0.5) | 2.05 (0.3–13.89) | ||
| All others | 1562 | 33 (4.0) | 39 (4.8) | 1.08 (0.61–1.93) | 30 (3.7) | 35 (4.4) | 1.09 (0.65–1.85) | ||
| Surgical priority | 0.765 | 0.743 | |||||||
| Emergent/urgent | 806 | 23 (2.8) | 24 (3.0) | 1.04 (0.53–2.06) | 25 (3.0) | 30 (3.7) | 1.08 (0.61–1.93) | ||
| Elective | 822 | 13 (1.6) | 16 (2.0) | 0.82 (0.31–2.15) | 7 (0.9) | 9 (1.1) | 0.94 (0.33–2.69) | ||
| Dual anti-platelet | 1.00 | 0.928 | |||||||
| Yes | 62 | 0 (0) | 0 (0) | – | 0 (0) | 1 (0.1) | – | ||
| No | 1566 | 36 (4.4) | 40 (5.0) | 0.97 (0.56–1.69) | 32 (3.9) | 38 (4.7) | 1.07 (0.64–1.77) | ||
| Anticoagulant use | 0.034 | 0.904 | |||||||
| Yes | 293 | 22 (2.7) | 21 (2.6) | 0.55 (0.25–1.21) | 11 (1.3) | 16 (2.0) | 1.32 (0.57–3.05) | ||
| No | 1335 | 14 (1.7) | 19 (2.4) | 1.81 (0.78–4.16) | 21 (2.6) | 23 (2.9) | 1.18 (0.62–2.25) | ||
| Chronic kidney disease | 0.522 | 0.056 | |||||||
| Yes | 196 | 9 (1.1) | 5 (0.6) | 0.54 (0.14–2.15) | 3 (0.4) | 10 (1.2) | 3.33 (0.89–12.55) | ||
| No | 1432 | 27 (3.3) | 35 (4.4) | 1.07 (0.57–2,00) | 29 (3.5) | 29 (3.6) | 0.88 (0.5–1.53) | ||
OR (95% CI) and P-value for interaction were from logistic regression. Models were adjusted for age, sex, APACHE III score at the time of admission, admission type, admission source, surgery priority, pre-surgical comorbidities [hypertension, diabetes mellitus, dyslipidaemia, heart failure, myocardial infarction, atrial fibrillation, prior percutaneous coronary intervention, prior coronary artery bypass grafting, peripheral vascular disease, cerebrovascular disease, chronic obstructive pulmonary disease, chronic kidney disease (without renal replacement therapy), dementia, human immunodeficiency virus, malignancy], surgical procedure and Charlson comorbidity index category.
APACHE: Acute Physiology and Chronic Health Evaluation; CI: confidence interval; CSICU: cardiac surgical intensive care unit; H2RB; histamine-2 receptor blocker; ITT: intention-to-treat; MCS: mechanical circulatory support; OR; odds ratio; PPI, proton pump inhibitor.