Reflected Shadows of Chronic Hepatitis C Virus Infection on its Victims Undergoing Coronary Artery Bypass Grafting Surgery: 10-Years’ Experience | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 2, Volume 93, Issue 1, October 2023, Page 6897-6807 PDF (572.68 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2023.320226 | ||||
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| Abstract | ||||
| Background: Due to the improvement of the treatment lines for the victims of chronic hepatitis C viral (HCV) infection, more survivors elapsed and a larger cohort of patients undergoing coronary artery bypass grafting (CABG) surgery is frequently operated upon. Their hepatic condition represents a surgical challenge because of the higher risk of postoperative complications and mortality. Objective:This study aimed to trace the impact of chronic HCV infection in patients undergoing CABG in the immediate postoperative period and to identify the predictive risk factors involved in the worse outcomes. Patients and Methods: This retrospective comparative study included 421 patients presented with ischemic heart disease (IHD) and operated upon by CABG. They were divided into group (A) including chronic HCV infection (196) patients while group (B) including the “free” of HCV infection (225) patients. Results: Multivariable logistic regression analysis showed that higher model for end-stage liver disease (MELD) score (OR: 3.140 (95% CI: 1.025-10.964); p= 0.019), lower preoperative platelets count (OR: 3.650 (95% CI: 1.166-12.778); p= 0.023), higher preoperative total bilirubin (OR: 1.256 (95% CI: 1.035-1.859); p= 0.021), higher preoperative creatinine (OR: 0.528 (95% CI: 0.345-1.012); p= 0.028) and prolonged cardiopulmonary bypass (CPB) time (OR: 1.145 (95% CI: 0.985-1.925); p= 0.020) were the significant predictors of postoperative morbidity and higher MELD score (OR: 3.220 (95% CI: 1.198-9.130); p= 0.018) and intraoperative blood transfusion (OR: 3.201 (95% CI: 1.595-6.411); p= 0.020) were the significant predictors of perioperative mortality. Conclusion: Identification and careful evaluation of the predictive risk factors may reduce serious post-surgical adverse outcomes. Greater careful consideration should be offered to patients with preoperative high MELD score, low platelets count, high total bilirubin and high creatinine. We recommend using the MELD score as a risk model in this subset of patients in prediction of the postoperative morbidity and mortality along with the currently used ones, which should involve hepatic dysfunction in its risk scoring system. | ||||
| Keywords | ||||
| Chronic HCV infection; CABG; HCV | ||||
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