Key result
Undergoing cardiac surgery at hospitals with the highest proportion of hematologic malignancy patients was associated with a lower risk of acute kidney injury (OR 0.68) compared to hospitals with the lowest proportion.
Why the study?
Perioperative management of chronic lymphocytic leukemia patients is complex due to immunosuppression and infection risks, but the impact of hospital hematologic malignancy patient proportions on their cardiac surgery outcomes was unknown.
Does treatment at hospitals with a higher proportion of hematologic malignancy patients improve outcomes in chronic lymphocytic leukemia patients undergoing cardiac surgery?
Cohort (n=6,357)
Yes
Does treatment at hospitals with a higher proportion of hematologic malignancy patients improve outcomes in chronic lymphocytic leukemia patients undergoing cardiac surgery?
Hospital experience with hematologic malignancies significantly impacts perioperative outcomes for CLL patients undergoing cardiac surgery, reducing AKI and respiratory failure but increasing transfusion and acute heart failure risks.
Answers are grounded in this paper and cite their sources.
Higher hematologic malignancy volume centers were associated with fewer complications in CLL cardiac surgery; leaves open prospective validation before changing referral patterns.
OBJECTIVE: This study aimed to investigate the impact of the proportion of hematologic malignancy patients in hospitals on the prognosis of chronic lymphocytic leukemia (CLL) patients undergoing cardiac surgery. Perioperative management of CLL patients is complex, particularly regarding immunosuppression and infection risks. METHODS: This retrospective study utilized data from the National Inpatient Sample (NIS) from 2010 to 2021. Adult CLL patients undergoing cardiac surgery were included, categorizing hospitals into five quintiles based on hematologic malignancy patient proportions. Outcomes included in-hospital mortality, acute kidney injury (AKI), postoperative bleeding, and infections. RESULTS: AKI incidence was significantly lower in the Q5 group (OR: 0.68, 95% CI: 0.49-0.97), as was the rate of respiratory failure (OR: 0.53, 95% CI: 0.35-0.79). However, the rates of transfusion and acute heart failure were significantly higher in Q5 (acute heart failure OR: 1.70, 95% CI: 1.07-2.77). No significant differences were found in in-hospital mortality or other complications. CONCLUSION: The proportion of hematologic malignancy patients affects CLL patient outcomes, with higher proportions linked to lower AKI and respiratory failure rates but increased transfusion and heart failure risks. Further research is warranted.
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Miao et al. (2025) conducted a cohort in Chronic lymphocytic leukemia undergoing cardiac surgery (n=6,357). High hospital proportion of hematologic malignancy patients (Quintile 5) vs. Low hospital proportion of hematologic malignancy patients (Quintile 1) was evaluated on Acute kidney injury (AKI) (OR 0.68, 95% CI 0.49-0.97, p=0.006). Undergoing cardiac surgery at hospitals with the highest proportion of hematologic malignancy patients was associated with a lower risk of acute kidney injury (OR 0.68) compared to hospitals with the lowest proportion.
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