Cobert J.Frere Z.Wongsripuemtet P.Ohnuma T.Krishnamoorthy V.Fuller M.Chapman A.C.Yaport M.Ghadimi K.Bartz R.Raghunathan K.Mahidol University2024-07-062024-07-062024-01-01Journal of Cardiothoracic and Vascular Anesthesia (2024)10530770https://repository.li.mahidol.ac.th/handle/20.500.14594/99367Objectives: To examine trends in the prevalence of multiorgan dysfunction (MODS), utilization of multi-organ support (MOS), and mortality among patients undergoing cardiac surgery with MODS who received MOS in the United States. Design: Retrospective cohort study. Setting: 183 hospitals in the Premier Healthcare Database. Participants: Adults ≥18 years old undergoing high-risk elective or non-elective cardiac surgery. Interventions: none. Measurements and Main Results: The exposure was time (consecutive calendar quarters) January 2008 and June 2018. We analyzed hospital data using day-stamped hospital billing codes and diagnosis and procedure codes to assess MODS prevalence, MOS utilization, and mortality. Among 129,102 elective and 136,190 non-elective high-risk cardiac surgical cases across 183 hospitals, 10,001 (7.7%) and 21,556 (15.8%) of patients developed MODS, respectively. Among patients who experienced MODS, 2,181 (22%) of elective and 5,425 (25%) of non-elective cardiac surgical cases utilized MOS. From 2008-2018, MODS increased in both high-risk elective and non-elective cardiac surgical cases. Similarly, MOS increased in both high-risk elective and non-elective cardiac surgical cases. As a component of MOS, mechanical circulatory support (MCS) increased over time. Over the study period, risk-adjusted mortality, in patients who developed MODS receiving MOS, increased in high-risk non-elective cardiac surgery and decreased in high-risk elective cardiac surgery, despite increasing MODS prevalence and MOS utilization (p<0.001). Conclusions: Among patients undergoing high-risk cardiac surgery in the United States, MODS prevalence and MOS utilization (including MCS) increased over time. Risk-adjusted mortality trends differed in elective and non-elective cardiac surgery. Further research is necessary to optimize outcomes among patients undergoing high-risk cardiac surgery.MedicineArticleSCOPUS10.1053/j.jvca.2024.04.0382-s2.0-8519693497315328422