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. 2024 Jan 23;19(1):23.
doi: 10.1186/s13019-024-02499-z.

Nomogram for predicting major bleeding after off-pump coronary artery bypass grafting

Jianqin Zhu  1 , Zhenjun Wu  2 , Guiming Huang  3 , Yuting Zhong  4 , Cheng Peng  5
Affiliations

Nomogram for predicting major bleeding after off-pump coronary artery bypass grafting

Jianqin Zhu et al. J Cardiothorac Surg. .

Abstract

Objective: The purpose of this investigation is to develop a novel nomogram for predicting major bleeding following off-pump coronary artery bypass grafting (CABG).

Methods: Between January 2012 and December 2022, 541 patients who underwent off-pump isolated primary CABG were included in a retrospective analysis. The primary outcome measure after off-pump CABG was major bleeding. Based on the outcomes of a multivariate analysis, nomograms were constructed. Using receiver operating characteristic analysis and calibration, the predictive accuracy of the nomograms was assessed. Using decision curve analysis (DCA), the clinical benefit of the nomograms was determined.

Results: We categorized 399 and 142 patients in the "no major bleeding group" and "major bleeding group", respectively. Age (odds ratio (OR) 1.038; 95% confidence interval (CI) 1.009-1.068; p = 0.009), body mass index (OR 0.913; 95% CI 0.849-0.982; p = 0.014), hemoglobin (OR 0.958; 95% CI 0.945-0.971; p < 0.001), sodium (OR 0.873; 95% CI 0.807-0.945; p = 0.001), blood urea nitrogen (OR 1.198; 95% CI 1.073-1.338; p = 0.001), and operation time (OR 1.012; 95% CI 1.008-1.017; p < 0.001) were independent predictors for major bleeding after off-pump CABG. The model based on independent predictors exhibited excellent discrimination and calibration, with good agreement between actual and nomogram-estimated probabilities of generalization. DCA demonstrated that nomogram-assisted decisions have a greater positive benefit than treating all patients or none.

Conclusions: The plotted nomogram accurately predicted major bleeding outcomes following off-pump CABG and may therefore contribute to clinical decision-making, patient treatment, and consultation services.

Keywords: Bleeding; Coronary artery bypass grafting; Nomogram; Off-pump.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A constructed nomogram for predicting major bleeding after off-pump CABG
Fig. 2
Fig. 2
Calibration plots for estimating major bleeding probabilities
Fig. 3
Fig. 3
Areas under the curves of the model for predicting major bleeding probabilities
Fig. 4
Fig. 4
Decision curves of the nomogram model
See this image and copyright information in PMC

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References

    1. Gaudino M, Angelini GD, Antoniades C, Bakaeen F, Benedetto U, Calafiore AM, et al. Off-pump coronary artery bypass grafting: 30 years of debate. J Am Heart Assoc. 2018;7(16):e009934. doi: 10.1161/JAHA.118.009934. - DOI - PMC - PubMed
    1. Amabile A, Williams EE, Rosati CM, Torregrossa G, Puskas JD. Off-pump coronary artery bypass grafting: how i teach it. Ann Thorac Surg. 2021;112(6):1741–1745. doi: 10.1016/j.athoracsur.2021.07.086. - DOI - PubMed
    1. Shaefi S, Mittel A, Loberman D, Ramakrishna H. Off-pump versus on-pump coronary artery bypass grafting-a systematic review and analysis of clinical outcomes. J Cardiothorac Vasc Anesth. 2019;33(1):232–244. doi: 10.1053/j.jvca.2018.04.012. - DOI - PubMed
    1. Møller CH, Steinbrüchel DA. Off-pump versus on-pump coronary artery bypass grafting. Curr Cardiol Rep. 2014;16(3):455. doi: 10.1007/s11886-013-0455-2. - DOI - PubMed
    1. Liu X, Yu Y, Wang L, Wang S, Gao Y, Ao H. Can C-reactive protein predict coagulation in off pump coronary artery bypass grafting? A cohort study. J Cardiothorac Surg. 2022;17(1):225. doi: 10.1186/s13019-022-01949-w. - DOI - PMC - PubMed

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