Evidence map›Paper›PMID 38357248›Full record

ArticleJACC. Advances2023

Presentation and Outcomes of Patients With Preoperative Critical Illness Undergoing Cardiac Surgery.

Thomas S Metkus, Carlos L Alviar, Vivian M Baird-Zars, Gregory W Barsness, David D Berg, Erin A Bohula, James A Burke, Christopher B Fordyce, Jianping Guo, Jason N Katz and 10 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 15 institutions in 2 countries.

Thomas S MetkusDivisions of Cardiology and Cardiac Surgery, Departments of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Carlos L AlviarLeon H. Charney Division of Cardiology, NYU Langone Medical Center, New York City, New York, USA.
Vivian M Baird-ZarsLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Gregory W BarsnessDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
David D BergLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Erin A BohulaLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
James A BurkeLehigh Valley Heart and Vascular Institute, Allentown, Pennsylvania, USA.
Christopher B FordyceDivision of Cardiology and Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada.
Jianping GuoLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Jason N KatzDivision of Cardiology, Duke University School of Medicine, Durham, North Carolina, USA.
Ellen C KeeleyDivision of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.
Venu MenonCardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
P Elliott MillerDepartment of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Connor G O'BrienDivision of Cardiology, Department of Medicine, University of California-San Francisco School of Medicine, San Francisco, California, USA.
Shashank S SinhaInova Heart and Vascular Institute, Inova Fairfax Medical Center, Falls Church, Virginia, USA.
Derek SoUniversity of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Bradley W TernusDivision of Cardiology, Department of Internal Medicine, University of Wisconsin, Madison, Wisconsin, USA.
Sagar VadharLehigh Valley Heart and Vascular Institute, Allentown, Pennsylvania, USA.
Sean van DiepenDivision of Cardiology, Department of Critical Care Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
David A MorrowLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Brigham and Women's Hospital · USLehigh Valley Hospital-Pocono · USCleveland Clinic · USDuke University · USInova Fairfax Hospital · USJohns Hopkins University · USMayo Clinic · USNYU Langone Health · USUniversity of Alberta · CAUniversity of British Columbia · CAUniversity of California, San Francisco · USUniversity of Florida · USUniversity of Ottawa · CAUniversity of Wisconsin–Madison · USYale University · US

Funding

NHLBI NIH HHS L30 HL134072
6 · The paper itself

Abstract

backgroundLittle is known about the prevalence and post-surgical outcomes associated with cardiac intensive care unit (CICU) therapeutics among CICU patients referred for cardiac surgery.

objectivesThe purpose of this study was to investigate the clinical characteristics and outcomes of CICU patients referred for cardiac surgery from the intensive care unit.

methodsWe analyzed characteristics and outcomes of CICU admissions referred from the CICU for cardiac surgery during 2017 to 2020 across 29 centers. The primary outcome was in-hospital mortality.

resultsAmong 10,321 CICU admissions, 887 (8.6%) underwent cardiac surgery, including 406 (46%) coronary artery bypass graftings, 201 (23%) transplants or ventricular assist devices, 171 (19%) valve surgeries, and 109 (12%) other procedures. Common indications for CICU admission included shock (33.5%) and respiratory insufficiency (24.9%). Preoperative CICU therapies included vasoactive therapy in 52.2%, mechanical circulatory support in 35.9%, renal replacement in 8.2%, mechanical ventilation in 35.7%, and 17.5% with high-flow nasal cannula or noninvasive positive pressure ventilation. In-hospital mortality was 11.7% among all CICU admissions and 9.1% among patients treated with cardiac surgery. After multivariable adjustment, pre-op mechanical circulatory support and renal replacement therapy were associated with mortality, while respiratory support and vasoactive therapy were not.

conclusionsNearly 1 in 12 contemporary CICU patients receive cardiac surgery. Despite high preoperative disease severity, CICU admissions undergoing cardiac surgery had a comparable mortality rate to CICU patients overall; highlighting the ability of clinicians to select higher acuity patients with a reasonable perioperative risk.

Indexed as

CABGcardiac intensive care unitcardiac surgeryICU

Identifiers

PMID38357248
PMCPMC10865183
OpenAlexW4323538458

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.