The primary objective for this retrospective Electronic Health Record (EHR) analysis is to evaluate the clinical outcomes associated with the utilization of a pulmonary artery catheter (PAC), for monitoring purposes, within patients undergoing cardiac surgeries (isolated coronary artery bypass graft \[CABG\], valve, aortic surgery, multi-procedures, other complex nonvalvular procedures and heart transplants). The study will be conducted using prospectively collected hospital inpatient data over a duration of over 5 years (Jan. 1, 2010 - June 30, 2015) using a large US electronic health database (Cerner HealthFacts; Kansas City, MO).
A retrospective study will be conducted using prospectively collected hospital inpatient data over a duration of over 5 years (Jan. 1, 2010 - June 30, 2015) using a large US electronic health database (Cerner HealthFacts; Kansas City, MO). Patients who underwent a qualifying cardiac surgery (verified through use of selected valid International Classification of Diseases-9 procedure codes and/or Current Procedural Terminology \[CPT\] codes) will be included. Each patient's cohort designation will be defined based upon whether he/she did or did not receive a pulmonary artery catheter (PAC) for monitoring purposes. Propensity scores, which take into account patient and hospital demographics, patient comorbidities, surgical type (isolated coronary artery bypass graft \[CABG\], valve, aortic surgery, multi-procedures, other complex nonvalvular procedures and heart transplants), and pre-operative condition (via an adapted EuroSCORE II) will be utilized to "match" patients who received a PAC for monitoring purposes with those who did not, to form a matched study cohort. Clinical outcomes will be monitored through index visit discharge and up to 90 days post index visit discharge.
Study Type
OBSERVATIONAL
Enrollment
6,844
PAC must be placed between the day of admission and the day following a qualifying cardiac surgery
Hospital mortality during index visit
Time frame: Admission through up to 180 days (hospital discharge)
Hospital length-of-stay (LOS)
Index hospital visit LOS
Time frame: Admission through up to 180 days (hospital discharge)
Hospital readmission
Rate of hospital readmissions
Time frame: Through 30 days
Hospital readmission
Rate of hospital readmissions
Time frame: Through 60 days
Hospital readmission
Rate of hospital readmissions
Time frame: Through 90 days
Major Adverse Cardiac Events (MACE)
Time frame: Through 30 days
Major Adverse Cardiac Events (MACE)
Time frame: Through 60 days
Major Adverse Cardiac Events (MACE)
Time frame: Through 90 days
Major morbidity composite
Time frame: Through 30 days
Major morbidity composite
Time frame: Through 60 days
Major morbidity composite
Time frame: Through 90 days
New organ failure (cardiovascular, respiratory, coagulation, liver systems, renal)
Time frame: Day 1 to discharge (up to 180 days)
Requirement for mechanical ventilation
Time frame: Day 1 to discharge (up to 180 days)
Hemorrhage requiring blood transfusion
Time frame: Day 1 to discharge (up to 180 days)
Acute kidney injury (KDIGO staging)
Time frame: Day 1 to day 10
Infectious complications
Time frame: Day 1 to discharge (up to 180 days)
Gastrointestinal complication (hepatic)
Time frame: Day 1 to discharge (up to 180 days)
Respiratory failure
Time frame: Day 1 to discharge (up to 180 days)
Sequential Organ Failure Assessment (SOFA) scores
Time frame: Day 1 to discharge (up to 180 days)
Neurologic complication
Time frame: Day 1 to discharge (up to 180 days)
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