The Association between Cytokines and 365-Day Readmission or Mortality in Adult Cardiac Surgery

作者：Allen D. Everett, Shama S. Alam, Sherry Owens, Devin M. Parker, Christine A. Goodrich, Donald S. Likosky, Heather Thiessen‐Philbrook, Moritz Wyler von Ballmoos, Kevin W. Lobdell, Todd A. MacKenzie, Jeffrey P. Jacobs, Chirag R. Parikh, Anthony W. DiScipio, David J. Malenka, Jeremiah R. Brown · 发表于：Journal of ExtraCorporeal Technology · 年份：2019 · DOI：10.1051/ject/201951201 · 被引用次数：12 · 研究领域：Heart Failure Treatment and Management、Cardiac Fibrosis and Remodeling、Mechanical Circulatory Support Devices

Cardiac surgery results in a multifactorial systemic inflammatory response with inflammatory cytokines, such as interleukin-10 and 6 (IL-10 and IL-6), shown to have potential in the prediction of adverse outcomes including readmission or mortality. This study sought to measure the association between IL-6 and IL-10 levels and 1-year hospital readmission or mortality following cardiac surgery. Plasma biomarkers IL-6 and IL-10 were measured in 1,047 patients discharged alive after isolated coronary artery bypass graft surgery from eight medical centers participating in the Northern New England Cardiovascular Disease Study Group between 2004 and 2007. Readmission status and mortality were ascertained using Medicare, state all-payer claims, and the National Death Index. We evaluated the association between preoperative and postoperative cytokines and 1-year readmission or mortality using Kaplan–Meier estimates and Cox’s proportional hazards modeling, adjusting for covariates used in the Society of Thoracic Surgeons 30-day readmission model. The median follow-up time was 1 year. After adjustment, patients in the highest tertile of postoperative IL-6 values had a significantly increased risk of readmission or death within 1 year (HR: 1.38; 95% CI: 1.03–1.85), and an increased risk of death within 1 year of discharge (HR: 4.88; 95% CI: 1.26–18.85) compared with patients in the lowest tertile. However, postoperative IL-10 levels, although increasing through tertiles, were not found t...