High central venous saturation after cardiac surgery is associated with increased organ failure and long-term mortality: an observational cross-sectional study

Balzer, Felix; Sander, Michael; Simon, Mark; Spies, Claudia; Habicher, Marit; Treskatsch, Sascha; Mezger, Viktor; Schirmer, Uwe; Heringlake, Matthias; Wernecke, Klaus-Dieter; Grubitzsch, Herko; von Heymann, Christian

doi:10.1186/s13054-015-0889-6

Critical Care

Table 5 Multivariate Cox regression analysis for short- and long-term survival

From: High central venous saturation after cardiac surgery is associated with increased organ failure and long-term mortality: an observational cross-sectional study

	Cox regression for in-hospital survival		Cox regression for 3-year follow-up survival
	HR unadjusted	HR adjusted	HR unadjusted	HR adjusted
Group L, S_cvO₂ < 60	1.377 (0.905–2.096),	2.124 (0.985–4.582),	1.126 (0.911–1.392),	1.209 (0.893–1.638),
Group L, S_cvO₂ < 60	P = 0.135	P = 0.055	P = 0272	P = 0.220
Group H, S_cvO₂ > 80	1.709 (1.244–2.348),	2.787 (1.565–4.964),	1.462 (1.244–1.718),	1.314 (1.033–1.672),
Group H, S_cvO₂ > 80	P = 0.001	P <0.001	P <0.001	P = 0.026
Age in years	1.039 (1.023–1.056),	1.096 (1.056–1.138),	1.050 (1.041–1.058),	1.044 (1.029–1.059),
Age in years	P <0.001	P <0.001	P <0.001	P <0.001
Type of surgery: valves	1.480 (1.083–2.022),	1.858 (0.991–3.458),	1.596 (1.369–1.860),	1.438 (1.124–1.840),
Type of surgery: valves	P = 0.014	P = 0.054	P <0.001	P = 0.004
Type of surgery: CABG + valves	1.469 (0.978–2.207),	1.747 (0.846–3.608),	1.835 (1.519–2.218),	1.281 (0.961–1.703),
Type of surgery: CABG + valves	P = 0.064	P = 0.132	P <0.001	P = 0.088
Duration of surgery, minutes			1.003 (1.002–1.004),	1.002 (1.001–1.004),
Duration of surgery, minutes			P <0.001	P = 0.010
Pre–operative ACEF score			2.609 (2.232–3.050),	1.379 (1.124–1.693),
Pre–operative ACEF score			P <0.001	P = 0.002
APACHE II score on ICU admission			1.049 (1.039–1.060),	1.030 (1.014–1.047),
APACHE II score on ICU admission			P <0.001	P <0.001
TISS score on ICU admission	1.088 (1.069–1.107),	1.100 (1.060–1.142),	1.056 (1.045–1.068),	1.028 (1.009–1.047),
TISS score on ICU admission	P <0.001	P <0.001	P <0.001	P = 0.004
Atrial fibrillation			2.147 (1.869–2.466),	1.674 (1.340–2.091),
Atrial fibrillation			P <0.001	P <0.001
COPD			1.798 (1.538–2.102),	1.497 (1.173–1.910),
COPD			P <0.001	P = 0.001
Diabetes mellitus	1.440 (1.070–1.939),	2.076 (1.173–3.675),	1.735 (1.512–1.990),	1.405 (1.137–1.736),
Diabetes mellitus	P = 0.016	P = 0.012	P <0.001	P = 0.002
Peripheral vascular disease	1.485 (1.100–2.006),	1.835 (1.064–3.164),	1.865 (1.601–2.174),	1.733 (1.364–2.201),
Peripheral vascular disease	P = 0.010	P = 0.029	P <0.001	P <0.001
Dobutamine, cumulative dosage mg/24 hours			0.999 (0.998–0.999),	0.999 (0.999–1.000),
Dobutamine, cumulative dosage mg/24 hours			P <0.001	P = 0.098
Enoximone, cumulative dosage mg/24 hours			1.000 (1.000–1.000),	0.999 (0.998–1.000),
Enoximone, cumulative dosage mg/24 hours			P = 0.002	P = 0.144
Norepinephrine, cumulative dosage mg/24 hours	1.014 (1.012–1.017),	1.018 (1.011–1.024),	1.015 (1.012–1.017),	1.016 (1.011–1.021),
Norepinephrine, cumulative dosage mg/24 hours	P <0.001	P <0.001	P <0.001	P <0.001

Values are presented as median (interquartile range). Hazard ratios (HRs) are adjusted for all pre-operative variables, intensive care unit (ICU) admission scores, and cumulative dosages (first 24 hours in ICU) of inotropic drugs that were significant in univariate Cox regression. Variables have been selected by using stepwise backward selection. Reference for type of surgery: coronary artery bypass graft (CABG); for grouping variable: group N (60 ≤ S_cvO₂ ≤ 80). ACEF, Age, Creatinine, and Ejection Fraction; APACHE II, Acute Physiology And Chronic Health Evaluation II; COPD, chronic obstructive pulmonary disease; H, high; L, low; S_cvO₂, central venous saturation; TISS, Therapeutic Intervention Scoring System.

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