Key result
Pre-operative EF <40% is linked to ~4.4-fold higher odds of prolonged hospitalization after CABG.
Why the study?
While reduced left ventricular EF is a known risk factor after CABG, its specific impact on immediate post-operative recovery, including prolonged hospital stay and need for mechanical circulatory support, is not fully understood.
Does a reduced pre-operative ejection fraction (EF <40%) increase the risk of prolonged hospital stay (>6 days) and need for mechanical circulatory support in patients undergoing isolated coronary artery bypass grafting?
Cohort (n=482)
No
Does a reduced pre-operative ejection fraction (EF <40%) increase the risk of prolonged hospital stay (>6 days) and need for mechanical circulatory support in patients undergoing isolated coronary artery bypass grafting?
Odds Ratio: 4.42 (95% CI 1.67–11.74)
p-value: p=0.003
Pre-operative left ventricular ejection fraction <40% independently predicts prolonged hospitalization (>6 days) and a nearly five-fold higher requirement for intra-aortic balloon pump support following isolated CABG.
Pre-operative EF <40% flags higher prolonged-stay risk after CABG; extends associations yet leaves open prospective validation.
Objective: While a reduced left ventricular ejection fraction (EF) is a well-known risk factor for adverse outcomes following coronary artery bypass grafting (CABG), its specific impact on the immediate post-operative recovery phase, such as the likelihood of an extended hospital stay or the need for mechanical circulatory support, is still not fully understood. Methods: We reviewed the records of 482 patients who underwent isolated CABG at our center in this retrospective cohort study. Patients were stratified into two categories based on their pre-operative EF: those with an EF <40% and those with an EF ≥40%. Our primary focus was observing prolonged hospital stays, defined as lasting more than 6 days. We also examined secondary recovery metrics, including time spent in the intensive care unit (ICU), duration of mechanical ventilation, and the utilization of an intra-aortic balloon pump (IABP). To pinpoint the true independent predictors of a prolonged stay, we applied multivariate logistic regression analysis. Results: Patients entering surgery with an EF <40% (n=25) experienced noticeably longer hospitalizations compared to the higher EF group (median 7 [6–10] days vs. 6 [5–7] days, p=0.001). They also required IABP support at a significantly higher rate (28.0% vs. 5.9%, p<0.001). While these patients tended to spend more time in the ICU, this trend narrowly missed statistical significance (p=0.057). After adjusting for other variables, having an EF <40% remained a strong, independent predictor of a prolonged hospital stay (odds ratio [OR]: 4.42, 95% confidence interval [CI]: 1.67–11.74, p=0.003). In addition, the duration of cardiopulmonary bypass emerged as another independent risk factor for extended hospitalization (OR: 1.007, 95% CI: 1.002–1.012, p=0.008). Conclusion: A reduced pre-operative EF is an independent driver of delayed hospital discharge and a heightened need for mechanical heart support following CABG. Tracking EF provides clinicians with a highly practical tool for anticipating early post-operative challenges and tailoring patient care accordingly.
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Bayici et al. (2026) conducted a cohort in Patients undergoing isolated coronary artery bypass grafting (CABG) (n=482). Pre-operative left ventricular ejection fraction (EF) <40% vs. Pre-operative left ventricular ejection fraction (EF) ≥40% was evaluated on Prolonged hospital stay (defined as >6 days) (OR 4.42, 95% CI 1.67-11.74, p=0.003). Pre-operative EF <40% independently predicted prolonged hospitalization (>6 days) after isolated CABG compared to EF ≥40% (OR 4.42, 95% CI 1.67-11.74, p=0.003).
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