Journal of Multidisciplinary Healthcare (Feb 2024)

Factors Associated with Acute Pulmonary Embolism in Patients with Hypoxia After off-Pump Coronary Artery Bypass Grafting: A Case-Control Study

  • Yu HY,
  • Bai YP,
  • Song XC,
  • Miao F,
  • Guo XL,
  • Wang X,
  • Su WL

Journal volume & issue
Vol. Volume 17
pp. 573 – 583

Abstract

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Hai-Yan Yu,1,* Yun-Peng Bai,2,* Xu-Chen Song,1 Fang Miao,1 Xiao-Ling Guo,1 Xing Wang,3 Wen-Ling Su1 1Department of Endocrinology, Tianjin Chest Hospital, Tianjin, 300070, People’s Republic of China; 2Department of Cardiac Surgery, Tianjin Chest Hospital, Tianjin, 300070, People’s Republic of China; 3Department of Imaging, Tianjin Chest Hospital, Tianjin, 300070, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wen-Ling Su, Department of Endocrinology, Tianjin Chest Hospital, No. 261 of Taierzhuang South Road, Jinnan District, Tianjin, 300070, People’s Republic of China, Tel +86-18702263436, Email [email protected]: This study aims to explore the factors linked to the occurrence of acute pulmonary thromboembolism (PE) within a cohort of patients exhibiting hypoxic saturation (oxygen saturation levels falling below 93%), subsequent to undergoing off-pump coronary artery bypass grafting (OPCABG).Methods: A retrospective case-control study was conducted. A total of 296 patients met the inclusion and exclusion criteria, divided into PE group (100 cases) and non-PE group (196 cases) according to whether they had PE or not. The preoperative and postoperative information of patients were collected and statistically analyzed.Results: The results from a multivariate logistic regression analysis indicated the following factors were independently linked to PE following OPCABG: history of smoking (OR = 3.019, 95% CI, 1.437– 6.634, P = 0.004), preoperative arterial oxygen partial pressure ≤ 78.9 mmHg (OR = 3.686, 95% CI, 1.708– 8.220, P = 0.001), presence of postoperative lower extremity deep venous thrombosis (OR = 4.125, 95% CI, 1.886– 9.310, P 6.76 mg/l (OR = 8.078, 95% CI, 3.749– 18.217, P 33.0 mmHg (OR = 10.743, 95% CI: 3.422– 37.203, P < 0.001). The developed nomogram exhibited a high predictive accuracy with an area under the curve of 0.913 (95% CI: 0.878– 0.948).Conclusion: When patients have a history of preoperative smoking, decreased preoperative arterial oxygen pressure, postoperative lower limb DVT, increased postoperative pulmonary artery pressure, and elevated postoperative D-Dimer and NT pro-BNP levels, it is recommended to take perioperative preventive measures, timely diagnostic evaluation, and if necessary, anticoagulant treatment. In addition, the results of this study may improve the diagnostic sensitivity of medical staff for postoperative PE in OPCABG, thereby increasing the detection rate and potentially reducing the need for excessive medical imaging procedures.Keywords: case-control study, off-pump coronary artery bypass grafting, prediction model, pulmonary embolism, risk factor

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