ABSTRACT
Objective: To build a clinical predictive model to determine the need for transfusing blood and its products in coronary artery bypass grafting [CABG] procedures in South East Asian population
Study Design: Analytical study
Place and Duration of Study: Section of Cardiothoracic Surgery, Aga Khan University Hospital, Karachi, from January 2006 to October 2014
Methodology: Information on pre-, intra- and postoperative variables were collected for all adult patients who underwent on-pump CABG. The patients grouped into those who received blood and its components, and those who did not. A univariate as well as multivariate logistic model was built to determine the predictors of transfusion
Results: A total of 3,550 patients underwent CABG and males were dominant in both groups [75 vs. 93%]. The transfusion rate was 56.4% [n=2001]. Age [adjusted OR 1.03, p < 0.001], obesity [1.50, p=0.001], tobacco use [1.29, p=0.001], and male gender [4.51, p < 0.001] found to be a stronger predictor. Among preoperative comorbidities, diabetes [1.20, p=0.016], myocardial infarction [1.22, p=0.009], preoperative creatinine [1.12, p=0.033], and left main vessel disease of > 50% [1.49, p < 0.001] were independently associated with the outcome. Compared to elective cases, transfusion rates were high in urgent and emergent cases [OR: 1.93 and 3.36 respectively, p < 0.001 for both]
Conclusion: Age, male gender, obesity, tobacco use, diabetes, myocardial infarction, high creatinine, urgent and emergent cases were independent predictors of transfusion in CABG procedure. This model can be utilized for preoperative risk stratification of patients and their management to improve the outcomes
ABSTRACT
To develop and validate a food frequency table [FFQ] for use in urban Pakistani population. A validation study. The Aga Khan University, Karachi, from June to November 2008. Healthy adult females, aged >/= 18 years who consented to be included in the study were inducted, while males, unhealthy females, aged below 18 years or who did not consent were excluded. The FFQ was administered once while 4, 24 hours recalls spread over a period of one year were administered as the reference method. Daily intakes for energy, protein, fat, and calcium intake were estimated for both the tools. Crude and energy adjusted correlations for nutrient intakes were computed for the FFQ and mean of 4, 24 hours recalls and serum N-telopeptide of type-I collagen [NTx]. The correlation coefficients for the FFQ with mean of 4, 24 hours recall ranged from 0.21 for protein to 0.36 for calcium, while the correlation for nutrient estimates from the FFQ with NTx ranged from -0.07 for calcium to 0.01 for energy. Highly significant correlations were found for nutrient intakes estimated from the FFQ vs. those estimated from the mean of 4, 24 hours recalls but no correlations was found between nutrient estimates from the FFQ and serum NTx levels. FFQ was concluded to be a valid tool for assessing dietary intake of adult females in Pakistan.