Abstract 16982: Anti-inflammatory Cytokines and the Association of 365-day Readmission or Mortality in Cardiac Surgery
Purpose: Inflammatory cytokines, such as Interleukin-6 (IL-6) and Interleukin-10 (IL-10), have shown potential in prediction of adverse outcomes including readmission or mortality, after cardiac surgery. This study sought to measure the relationship between IL-6 and IL-10 levels and 365-day hospital readmission and mortality following cardiac surgery.
Methods: Plasma IL-6 and IL-10 were measured in 1393 patients discharged alive after isolated coronary artery bypass graft surgery from 8 medical centers in the Northern New England Cardiovascular Disease Study Group (NNE) cohort between 2004 and 2007. Readmission status and mortality were ascertained using Medicare, state all-payer claims, and the National Death Index. Biomarkers were measured using MSD multiplex assays. We evaluated the association between tercile cut-points of post-operative day one cytokines and 365-day readmission or mortality using Kaplan-Meier estimates and Cox’s Proportional Hazards modeling.
Results: The NNE cohort contained 1047 patients with post-operative inflammatory biomarker measurements. Median follow-up time was 365 days. After adjustment, compared to patients in the lowest tercile, patients in the highest tercile of post-operative 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 one year of discharge (HR: 4.88; 95%CI: 1.26-18.85). However, post-operative IL-10 levels were not found to be associated independently with 365-day readmission or mortality (HR: 1.25; 95%CI: 0.93-1.69).
Conclusions: Pro-inflammatory cytokines IL-6 and IL-10 may be markers of ischemia-reperfusion injury and show promise in predicting readmission and mortality following cardiac surgery. Further research will be needed to elucidate the complex inflammatory response following cardiac surgery and their relationship to outcome quality metrics such as readmission and mortality.
Author Disclosures: A. Everett: None. C. Parikh: None. D. Likosky: None. J. Jacobs: Consultant/Advisory Board; Modest; Chair of STS Public Reporting Task Force. S. Alam: None. H. Philbrook: None. M. Wyler von Ballmoos: None. K. Lobdell: None. T.A. MacKenzie: None. J. Brown: None.
- © 2016 by American Heart Association, Inc.