Key result
Surgical risk, anemia, poor nutrition, and bypass time independently predict 30-day postoperative complication severity.
Why the study?
Open-heart surgery is associated with substantial postoperative morbidity, and the structural and process factors associated with the severity of 30-day postoperative complications rather than merely their presence or absence needed examination.
Observational (n=136)
No
In adults undergoing open-heart surgery, higher STS surgical mortality risk, preoperative anemia, poorer nutritional status (lower PNI), and longer cardiopulmonary bypass time are independently associated with greater 30-day postoperative complication severity, highlighting modifiable targets for preoperative optimization.
Answers are grounded in this paper and cite their sources.
Preoperative factors were associated with complication severity; hypothesis-generating for optimization trials before practice change.
Background: Open-heart surgery is associated with substantial postoperative morbidity. Guided by the Nursing Role Effectiveness Model, this study focused on the severity of 30-day postoperative complications rather than only the presence or absence of complications. Purpose: The study examined structural factors (health literacy, nutritional status, severity of comorbidities, anemia, and surgical mortality risk) and process factors (perception of patient-centered care, type of surgery, and cardiopulmonary bypass time) associated with complication severity after open-heart surgery. Patients and Methods: A prospective, single-center observational prognostic factor study with medical record review was conducted from June 2022 to July 2023 among 136 adult patients undergoing open-heart surgery at a tertiary hospital in Thailand. Data were collected from patient questionnaires and medical records. The primary outcome was 30-day complication severity measured using the Comprehensive Complication Index. Bivariate analyses and multiple linear regression were performed, with prespecified covariates selected based on clinical relevance. Results: Participants had a mean age of 61.32 years (SD = 13.09), and 61.8% were male. The mean Comprehensive Complication Index score was 37.25 (SD = 14.70). In the adjusted model, surgical mortality risk (standardized beta = 0.345, p < 0.001), anemia (standardized beta = 0.224, p = 0.018), nutritional status (standardized beta = − 0.218, p = 0.011), and cardiopulmonary bypass time (standardized beta = 0.198, p = 0.034) were independently associated with complication severity. Health literacy, comorbidity severity, and perceived patient-centered care were not statistically significant. Conclusion: Surgical mortality risk, anemia, nutritional status, and cardiopulmonary bypass time were key factors associated with 30-day complication severity. These findings support preoperative optimization of hematological and nutritional status and careful intraoperative management to reduce postoperative morbidity; however, interpretation should consider the single-center design and available covariates.
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nakkhamhaeng et al. (2026) conducted an observational in Open-heart surgery (coronary artery disease and valvular heart conditions) (n=136). Structural factors (surgical mortality risk, anemia, nutritional status, health literacy, comorbidity severity) and process factors (cardiopulmonary bypass time, perceived patient-centered care) was evaluated on 30-day postoperative complication severity measured using the Comprehensive Complication Index (CCI) (Standardized beta 0.345 (surgical mortality risk), 0.224 (anemia), -0.218 (nutritional status), 0.198 (CPB time), 95% CI 0.159-0.480, p=<0.001). Surgical mortality risk (β=0.345, p<0.001), anemia (β=0.224, p=0.018), nutritional status (β=-0.218, p=0.011), and bypass time (β=0.198, p=0.034) predicted 30-day complication severity.
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