Effects of decreased preoperative endotoxin core antibody levels on long-term mortality after coronary artery bypass graft surgery.

Authors

• Eugene W Moretti
• Mark F Newman
• Lawrence H Muhlbaier
• David Whellan
• Rebecca P Petersen
• Daniel Rossignol
• Charles B McCants
• Barbara Phillips-Bute
• Elliott Bennett-Guerrero

Publication/Presentation Date

7-1-2006

Abstract

HYPOTHESIS: Decreased preoperative levels of antiendotoxin core antibody (EndoCAb) in patients undergoing cardiac surgery with cardiopulmonary bypass are associated with increased long-term mortality.

DESIGN: Observational study.

SETTING: Academic medical center.

PATIENTS: A total of 474 patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass.

INTERVENTIONS: Preoperative serum IgM EndoCAb levels were determined, and established preoperative risk factors were assessed. Patients were assigned a risk score using a validated method.

MAIN OUTCOME MEASURES: The primary end point was mortality. Statistical analysis used the Cox proportional hazards regression model with log EndoCAb as the predictor of interest and Parsonnet additive risk score as a covariate. Kaplan-Meier survival curves were generated to visually compare groups with high vs low EndoCAb levels.

RESULTS: Forty-six deaths occurred in 5 years. Annual follow-up rates during the 5 years were 100%, 94%, 93%, 98%, and 98% for the 1-, 2-, 3-, 4-, and 5-year periods, respectively. Parsonnet additive risk score (hazard ratio, 1.07; 95% confidence interval [CI], 1.04-1.11; P < .001) and log EndoCAb (hazard ratio, 0.73; 95% CI, 0.53-0.99; P = .04) were independent predictors of long-term mortality in the final model. Kaplan-Meier analysis revealed that the preoperative EndoCAb level was significantly associated with mortality up to 5 years (P = .01 by log-rank test).

CONCLUSION: Lower preoperative serum EndoCAb level is a significant predictor of long-term mortality independent of other known risk factors.

Volume

141

Issue

7

First Page

637

Last Page

641

ISSN

0004-0010

Published In/Presented At

Moretti, E. W., Newman, M. F., Muhlbaier, L. H., Whellan, D., Petersen, R. P., Rossignol, D., McCants, C. B., Jr, Phillips-Bute, B., & Bennett-Guerrero, E. (2006). Effects of decreased preoperative endotoxin core antibody levels on long-term mortality after coronary artery bypass graft surgery. Archives of surgery (Chicago, Ill. : 1960), 141(7), 637–642. https://doi.org/10.1001/archsurg.141.7.637

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

16847232

Department(s)

Administration and Leadership

Document Type

Article