CPB and Aortic Cross-Clamp Durations and ICU Length of Stay After CABG Retrospective Observational Cohort Study

Официальное название

Association of Cardiopulmonary Bypass and Aortic Cross-Clamp Durations With Intensive Care Unit Length of Stay in Elective Isolated Coronary Artery Bypass Graft Surgery: A Retrospective Observational Cohort Study

Обзор

Cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC) durations are important intraoperative factors that may influence postoperative recovery following coronary artery bypass graft (CABG) surgery. Prolonged CPB and ACC durations may be associated with increased postoperative morbidity and extended intensive care unit (ICU) stay. This retrospective observational cohort study aims to evaluate the independent associations of CPB and ACC durations with postoperative ICU length of stay in adult patients undergoing elective isolated CABG surgery. Electronic medical records of eligible patients who underwent surgery between January 1, 2019, and December 31, 2025, at a single tertiary care center will be retrospectively reviewed. Multivariable regression analyses will be performed to assess these associations after adjustment for clinically relevant potential confounders.

Подробное описание

Cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC) are essential components of coronary artery bypass graft (CABG) surgery. Prolonged CPB and ACC durations may contribute to systemic inflammatory responses, alterations in organ perfusion, and postoperative morbidity, potentially resulting in delayed postoperative recovery and prolonged intensive care unit (ICU) stay.

This single-center retrospective observational cohort study is designed to investigate the association of CPB and ACC durations with postoperative ICU length of stay in adult patients undergoing elective isolated CABG surgery. The electronic medical records of patients who underwent elective isolated CABG surgery between January 1, 2019, and December 31, 2025, will be retrospectively reviewed.

Demographic and preoperative clinical characteristics, including age, sex, body mass index, left ventricular ejection fraction, diabetes mellitus, chronic obstructive pulmonary disease, and chronic kidney disease, will be collected. Intraoperative data will include operative duration, CPB duration, and ACC duration. Postoperative ICU length of stay will be defined as the time from postoperative ICU admission to transfer from the ICU to the hospital ward.

The primary outcome of the study is postoperative ICU length of stay. CPB and ACC durations will be evaluated as continuous exposure variables measured in minutes. Their independent associations with ICU length of stay will be assessed using separate multivariable regression models adjusted for clinically relevant potential confounders. The distribution of ICU length of stay will be evaluated before multivariable analysis. Depending on the distributional characteristics of the outcome, multivariable linear regression after appropriate transformation or a generalized linear model with an appropriate distribution and link function will be used.

The study involves retrospective analysis of routinely collected clinical data and does not include any additional intervention, diagnostic procedure, or treatment related to the research.

Вмешательства

• Другое Cardiopulmonary Bypass Duration
  Cardiopulmonary bypass duration, defined as the total duration of cardiopulmonary bypass during elective isolated coronary artery bypass graft surgery and recorded in minutes. This exposure will be evaluated as a continuous variable based on routinely collected perfusion records.
• Другое Aortic Cross-Clamp Duration
  Aortic cross-clamp duration, defined as the total duration of aortic cross-clamping during elective isolated coronary artery bypass graft surgery and recorded in minutes. This exposure will be evaluated as a continuous variable based on routinely collected operative and perfusion records.

Первичные конечные точки

• Postoperative Intensive Care Unit Length of Stay [Срок оценки: Up to 30 days after surgery]

Вторичные конечные точки (4)

• Postoperative Atrial Fibrillation [Срок оценки: Up to 30 days after surgery]
• Acute Kidney Injury [Срок оценки: Up to 30 days after surgery]
• Postoperative Respiratory Failure [Срок оценки: Up to 30 days after surgery]
• 30-Day All-Cause Mortality [Срок оценки: Within 30 days after surgery]

Критерии участия

Критерии включения

• Age 18 years or older
• Underwent elective isolated coronary artery bypass graft surgery
• Surgery performed between January 1, 2019, and December 31, 2025
• Availability of complete electronic medical records required for the study analyses

Критерии исключения

• Emergency coronary artery bypass graft surgery
• Concomitant valve surgery
• Concomitant aortic surgery
• Reoperation cases
• Incomplete study-related data
• Intraoperative death

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Turkey (Türkiye) · 1 центр

• Fatma Acil — Diyarbakır

Публикации

• Anastasiadis K, Antonitsis P, Voucharas C, Apostolidou-Kiouti F, Deliopoulos A, Haidich AB, Argiriadou H. Minimal invasive extracorporeal circulation versus conventional cardiopulmonary bypass in cardiac surgery: a contemporary systematic review and meta-analysis. Eur J Cardiothorac Surg. 2025 Mar 28;67(4):ezaf112. doi: 10.1093/ejcts/ezaf112. PMID 40131383

Идентификаторы

NCT: NCT07711951 · 05.06.2026-276

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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