Dataset Information

Sleep apnea and recurrent heart failure hospitalizations after coronary artery bypass grafting.

ABSTRACT:

Study objectives

Sleep apnea is prevalent in patients undergoing coronary artery bypass grafting (CABG). We investigated the relationship between sleep apnea and recurrent heart failure hospitalizations in patients undergoing nonurgent CABG.

Methods

Between November 2013 and December 2018, 1,007 patients completed a sleep study prior to CABG and were followed up until April 2020. Recurrent heart failure hospitalizations were analyzed by Poisson, negative binomial, Andersen-Gill, and joint frailty models, with partial and full adjustment for covariates.

Results

At an average follow-up of 3.3 years, the number of patients with 0, 1, or ≥ 2 heart failure hospitalizations were 908 (90.2%), 62 (6.2%), and 37 (3.7%), respectively. The total number of heart failure hospitalizations was 179, comprising 62 (35%) first and 117 (65%) repeat events. The numbers of heart failure hospitalizations for the sleep apnea (n = 513, 50.9%) and nonsleep apnea groups were 127 and 52, respectively. Negative binomial regression demonstrated that sleep apnea was associated with recurrent heart failure hospitalizations (fully adjusted rate ratio, 1.71; 95% confidence interval [CI], 1.12-2.62; P = .013). Similar results were found in Poisson (1.63; 95% CI, 1.15-2.31; P = .006), Andersen-Gill (1.66; 95% CI, 1.01-2.75; P = .047), and joint frailty models (1.72; 95% CI, 1.00-3.01; P = .056).

Conclusions

In patients after CABG, repeat events accounted for two-thirds of heart failure hospitalizations. Sleep apnea was independently associated with recurrent heart failure hospitalizations.

Citation

Teo YH, Tam WT, Koo C-Y, et al. Sleep apnea and recurrent heart failure hospitalizations after coronary artery bypass grafting. J Clin Sleep Med. 2021;17(12):2399-2407.

SUBMITTER: Teo YH

PROVIDER: S-EPMC8726383 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Publications

Sleep apnea and recurrent heart failure hospitalizations after coronary artery bypass grafting.

Teo Yao Hao YH Tam Wilson W WW Koo Chieh-Yang CY Aung Aye-Thandar AT Sia Ching-Hui CH Wong Raymond C C RCC Kong William W Poh Kian-Keong KK Kofidis Theodoros T Kojodjojo Pipin P Lee Chi-Hang CH

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 20211201 12

<h4>Study objectives</h4>Sleep apnea is prevalent in patients undergoing coronary artery bypass grafting (CABG). We investigated the relationship between sleep apnea and recurrent heart failure hospitalizations in patients undergoing nonurgent CABG.<h4>Methods</h4>Between November 2013 and December 2018, 1,007 patients completed a sleep study prior to CABG and were followed up until April 2020. Recurrent heart failure hospitalizations were analyzed by Poisson, negative binomial, Andersen-Gill, a ...[more]

PMID: 34216202

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Project description:ObjectiveWe evaluated whether interhospital variation in mortality rates for coronary artery bypass grafting was driven by complications and failure to rescue.MethodsAn observational study was conducted among 83,747 patients undergoing isolated coronary artery bypass grafting between July 2011 and June 2017 across 90 hospitals. Failure to rescue was defined as operative mortality among patients developing complications. Complications included the Society of Thoracic Surgeons 5 major complications (stroke, surgical reexploration, deep sternal wound infection, renal failure, prolonged intubation) and a broader set of 19 overall complications. After creating terciles of hospital performance (based on observed:expected mortality), each tercile was compared on the basis of crude rates of (1) major and overall complications, (2) operative mortality, and (3) failure to rescue (among major and overall complications). The correlation between hospital observed and expected (to address confounding) failure to rescue rates was assessed.ResultsMedian Society of Thoracic Surgeons predicted mortality risk was similar across hospital observed:expected mortality terciles (P = .831). Mortality rates significantly increased across terciles (low tercile: 1.4%, high tercile: 2.8%). Although small in magnitude, rates of major (low tercile: 11.1%, high tercile: 12.2%) and overall (low tercile: 36.6%, high tercile: 35.3%) complications significantly differed across terciles. Nonetheless, failure to rescue rates increased substantially across terciles among patients with major (low tercile: 9.1%, high tercile: 14.3%) and overall (low tercile: 3.3%, high tercile: 6.8%) complications. Hospital observed and expected failure to rescue rates were positively correlated among patients with major (R2 = 0.14) and overall (R2 = 0.51) complications.ConclusionsThe reported interhospital variability in successful rescue after coronary artery bypass grafting supports the importance of identifying best practices at high-performing hospitals, including early recognition and management of complications.

Dataset Information

Sleep apnea and recurrent heart failure hospitalizations after coronary artery bypass grafting.

Study objectives

Methods

Results

Conclusions

Citation

Publications

Sleep apnea and recurrent heart failure hospitalizations after coronary artery bypass grafting.

Similar Datasets

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