Table E1. Preoperative Laboratory Tests
SUPPLEMENTAL MATERIAL
Table E1. Preoperative Laboratory Tests
Variable / Unmatched Patients / Matched PatientsNon-CLL (n=55,917) / CLL
(n=157) / P / Non-CLL
(n=471) / CLL
(n=157) / P
na / Mean±SD / na / Mean±SD / na / Mean±SD / na / Mean±SD
Bilirubin (mg/dL)b / 51,925 / 0.4/0.6/1.0 / 148 / 0.4/0.6/1.0 / .3 / 439 / 0.4/0.6/1.1 / 148 / 0.4/0.6/1.0 / .7
Creatinine (mg/dL) / 55,522 / 1.2±0.85 / 155 / 1.3±0.82 / <.0001 / 467 / 1.3±0.9 / 155 / 1.3±0.82 / .6
BUN (mg/dL) / 55,519 / 21±13 / 155 / 24±10 / <.0001 / 467 / 24±13 / 155 / 24±10 / .7
Total cholesterol (mg/dL) / 41,940 / 176±46 / 117 / 153±35 / <.0001 / 355 / 153±43 / 117 / 153±35 / .5
LDL cholesterol (mg/dL) / 41,348 / 101±39 / 116 / 87±28 / <.0001 / 351 / 83±34 / 116 / 87±28 / .08
Triglycerides (mg/dL) / 41,568 / 141±108 / 117 / 126±82 / .07 / 352 / 135±116 / 117 / 126±82 / .7
MCH (pG) / 134 / 30±2.2
MCHC (g/dL) / 144 / 33±1.3
MPV (fL) / 135 / 11±0.97
Neutrophil (%)b / 130 / 7/26/63
Absolute lymphocyte (k/μL)b / 45 / 4.3/13/33
Lymphocyte (%)b / 130 / 25/68/89
Absolute monocyte (k/μL) / 122 / 0.71±0.57
Monocyte (%) / 124 / 5.0±4.5
Absolute eosinophil (k/μL) / 114 / 0/0.15/0.38
Eosinophil (%) / 117 / 0/1.0/3.0
Absolute basophil (k/μL)b / 102 / 0/0.01/0.10
Basophil (%)b / 104 / 0/0.01/0.10
IgA (mg/dL) / 27 / 124±80
IgG (mg/dL) / 29 / 768±278
IgM (mg/dL) / 28 / 40±34
Albumin (g/dL) / 141 / 4.1±0.52
INR / 138 / 1.1±0.16
a. Patients with data available.
b. 15th/50th/85th percentiles.
BUN=blood urea nitrogen; CLL=chronic lymphocytic leukemia; HDL=high-density lipoprotein; INR=international normalized ratio; LDL=low-density lipoprotein; MCH=mean corpuscular hemoglobin; MCHC=mean corpuscular hemoglobin concentration; MPV=mean platelet volume.
Table E2. Risk Factors Associated with CLL: Parsimonious Model
Factor / Estimate ± SE / P / Reliability (%)aWhite race / 0.97±0.46 / .04 / 75
Age / 0.058±0.0086 / <.0001 / 99
Height (cm)b / 3.16±0.78 / <.0001 / 68
Preoperative HDL (mg/dL) / -0.032±0.0086 / .002 / 99
LCx system disease >70% / -0.63±0.18 / .0007 / 82
Intercept / -12.09±1.2 / <.0001 / —
Note: C-statistic=.73.
a. Percent of times factor appeared in 1,000 bootstrap models.
b. (Height/180)2, squared transformation.
CLL=chronic lymphocytic leukemia; HDL=high-density lipoprotein; LCx=left circumflex; SE=standard error.
Table E3. Hospital Mortality and Complications in CLL Patients Stratified by Rai Risk Classifications:
Unadjusted Analysis
Variable / Rai Risk Classificationa / PLow Risk
(n=79) / Intermediate Risk (n=13) / High Risk
(n=38) / Remission
(n=12)
nb /
No. (%) or Mean±SD / nb /
No. (%) or Mean±SD / nb /
No. (%) or Mean±SD / nb /
No. (%) or Mean±SD
Outcome
Hospital death / 79 / 1(1.3) / 13 / 0(0) / 38 / 2(5.3) / 12 / 1(8.3) / .8
Stroke / 79 / 4(5.1) / 13 / 0(0) / 38 / 1(2.6) / 12 / 1(8.3) / .4
Renal failure requiring dialysis / 77 / 0(0) / 13 / 0(0) / 36 / 1(2.8) / 11 / 0(0) / .3
Prolonged ventilation
(>24 hours) / 61 / 4(6.6) / 9 / 1(11) / 27 / 2(7.4) / 11 / 2(18) / .7
Atrial fibrillation/flutter / 65 / 29(45) / 12 / 3(25) / 30 / 10(33) / 11 / 3(27) / .6
Heart block / 71 / 0(0) / 11 / 0(0) / 32 / 0(0) / 11 / 0(0) / >.9
Length of stayc
Hospital (d) / 79 / 5.3/8.0/14 / 13 / 5.4/8.2/30 / 38 / 5.3/16/26 / 12 / 6.4/9.6/32 / .02*
ICU (h) / 79 / 22/29/97 / 13 / 24/47/358 / 38 / 23/47/127 / 12 / 22/46/377 / .7*
Reoperation for bleeding or tamponade / 79 / 2(2.5) / 13 / 2(15) / 38 / 1(2.6) / 12 / 1(8.3) / >.9
Deep sternal wound infection / 79 / 0(0) / 13 / 0(0) / 38 / 0(0) / 12 / 0(0) / >.9
Septicemia / 79 / 1(1.3) / 13 / 0(0) / 38 / 1(2.6) / 12 / 1(8.3) / .7
Pneumonia / 79 / 2(2.5) / 13 / 0(0) / 38 / 0(0) / 12 / 0(0) / .5
Urinary tract infection / 79 / 2(2.5) / 13 / 0(0) / 38 / 1(2.6) / 12 / 1(8.3) / .7
Central line infection / 79 / 0(0) / 13 / 0(0) / 38 / 1(2.6) / 12 / 1(8.3) / >.9
Blood product received
RBCs / 79 / 40(51) / 13 / 9(69) / 38 / 29(76) / 12 / 8(67) / .03
Platelets / 79 / 20(25) / 13 / 7(54) / 38 / 19(50) / 12 / 4(33) / .01
FFP / 79 / 11(14) / 13 / 2(15) / 38 / 6(16) / 12 / 3(25) / .9
Cryoprecipitate / 79 / 5(6.3) / 13 / 2(15) / 38 / 0(0) / 12 / 1(8.3) / .3
Any / 79 / 43(54) / 13 / 10(77) / 38 / 33(87) / 12 / 10(83) / .007
a. Low risk=class 0; intermediate risk=classes I and II; high risk=classes III and IV.
b. Patients with data available.
c. 15th/50th/85th percentiles.
* Natural Logarithmic transformation
CLL=chronic lymphocytic leukemia; FFP=fresh frozen plasma; ICU=intensive care unit; RBCs=red blood cells; SD=standard deviation.
Table E4. Hospital Mortality and Complications in CLL Patients Stratified by Preoperative
Chemotherapy Status
Variable / No Preoperative Chemotherapy(n=85) / Preoperative Chemotherapy
(n=29) / P
na / No. (%) or Mean±SD / na / No. (%) or Mean±SD
Outcome
Hospital death / 85 / 1(1.2) / 29 / 2(6.9) / .16
Stroke / 85 / 3(3.5) / 29 / 2(6.9) / .6
Renal failure requiring dialysis / 84 / 1(1.2) / 28 / 0(0) / >.9
Prolonged ventilation (>24 h) / 75 / 6(8) / 24 / 3(13) / .7
Atrial fibrillation/flutter / 73 / 33(45) / 24 / 6(25) / .08
Heart block / 77 / 0(0) / 25 / 0(0) / >.9
Length of stayb
Hospital (d) / 85 / 5.2/9.2/16 / 29 / 5.8/10/29 / .15
ICU (h) / 85 / 23/40/91 / 29 / 23/50/146 / .18
Reoperation for bleeding or tamponade / 85 / 3(3.5) / 29 / 1(3.4) / >.9
Deep sternal wound infection / 85 / 0(0) / 29 / 0(0) / >.9
Septicemia / 85 / 2(2.4) / 29 / 1(3.4) / >.9
Pneumonia / 85 / 1(1.2) / 29 / 0(0) / >.9
Urinary tract infection / 85 / 2(2.4) / 29 / 2(6.9) / .3
Central line infection / 85 / 2(2.4) / 29 / 1(3.4) / >.9
Blood product received
RBCs / 85 / 49(58) / 29 / 19(66) / .5
Platelets / 85 / 28(33) / 29 / 10(34) / .9
FFP / 85 / 11(13) / 29 / 7(24) / .15
Cryoprecipitate / 85 / 4(4.7) / 29 / 4(14) / .11
Any / 85 / 55(65) / 29 / 22(76) / .3
a. Patients with data available.
b. 15th/50th/85th percentiles.
CLL=chronic lymphocytic leukemia; FFP=fresh frozen plasma; ICU=intensive care unit; RBCs=red blood cells;
SD=standard deviation.
Table E5. In-Hospital Outcomes and Blood Products Transfused: Isolated Coronary Artery Bypass Grafting
Outcome / Matched Non-CLL Patients (n=112) / Matched CLL Patients (n=39) / Pna / No. (%) or Mean±SD / na / No. (%) or Mean±SD
Blood Products / 112 / 39
Total cryoprecipitate / 3(2.7) / 0(0) / .6
Total red blood cells / 61(54) / 22(56) / .8
Total fresh frozen plasma / 7(6.3) / 1(2.6) / .7
Total platelets / 12(11) / 6(15) / .4
Any transfusion / 64(57) / 24(62) / .6
Outcomes
Deep sternal wound infection / 112 / 4(3.6) / 39 / 0(0) / .6
Septicemia / 112 / 0(0) / 39 / 1(2.6) / .3
Permanent stroke / 112 / 2(1.8) / 39 / 1(2.6) / >.9
Reoperation for
bleeding/tamponade / 112 / 3(2.7) / 39 / 1(2.6) / >.9
Atrial fibrillation / 100 / 46(46) / 34 / 14(41) / .6
Renal failure requiring dialysis / 100 / 1(1.0) / 39 / 0(0) / >.9
Prolonged ventilation (>24 h) / 64 / 11(17) / 24 / 1(4.2) / .17
Hospital death / 112 / 3(2.7) / 39 / 0(0) / .6
Pneumonia / 112 / 1(0.89) / 39 / 1(2.6) / .4
Urinary tract infection / 112 / 2(1.8) / 39 / 0(0) / >.9
Central line infection / 112 / 0(0) / 39 / 0(0) / >.9
Length of stayb / 112 / 39
ICU (h) / 24/28/80 / 24/26/72 / .5
Hospital (d) / 5.3/8.2/15 / 6.3/9.2/16 / .2
a. Patients with data available.
b.15th/50th/85th percentiles.
CLL=chronic lymphocytic leukemia; SD=standard deviation.
Table E6. In-Hospital Outcomes and Blood Products Transfused: Valve Procedure with or without Coronary Artery Bypass Grafting
Outcome / Matched Non-CLL Patients (n=209) / Matched CLL Patients (n=71) / Pna / No. (%) or Mean±SD / na / No. (%) or Mean±SD
Blood Products / 209 / 71
Total cryoprecipitate / 18(8.6) / 2(2.8) / .12
Total red blood cells / 118(56) / 40(56) / >.9
Total fresh frozen plasma / 43(21) / 5(7) / .009
Total platelets / 64(31) / 22(31) / >.9
Any transfusion / 124(59) / 46(65) / .4
Outcomes
Deep sternal wound infection / 209 / 0(0) / 71 / 0(0) / >.9
Septicemia / 209 / 6(2.9) / 71 / 1(1.4) / .7
Permanent stroke / 209 / 1(0.48) / 71 / 3(4.2) / .05
Reoperation for
bleeding/tamponade / 209 / 8(3.8) / 71 / 3(4.2) / >.9
Atrial fibrillation / 179 / 77(43) / 57 / 23(40) / .7
Renal failure requiring dialysis / 193 / 7(3.6) / 68 / 0(0) / .19
Prolonged ventilation (>24 h) / 155 / 23(15) / 53 / 3(5.7) / .10
Hospital death / 209 / 5(2.4) / 71 / 0(0) / .3
Pneumonia / 209 / 6(2.9) / 71 / 1(1.4) / .7
Urinary tract infection / 209 / 8(3.8) / 71 / 3(4.2) / >.9
Central line infection / 209 / 6(2.9) / 71 / 1(1.4) / .7
Length of stayb / 209 / 71
ICU (h) / 23/42/161 / 22/28/96 / .3
Hospital (d) / 5.4/8.4/21 / 5.0/9.0/19 / .5
a. Patients with data available.
b.15th/50th/85th percentiles.
CLL=chronic lymphocytic leukemia; SD=standard deviation.
Table E7. In-Hospital Outcomes and Blood Products Transfused: Aortic Procedure
Outcome / Matched Non-CLL Patients (n=76) / Matched CLL Patients (n=24) / Pna / No. (%) or Mean±SD / na / No. (%) or Mean±SD
Blood Products / 76 / 24
Total cryoprecipitate / 12(16) / 2(8.3) / .5
Total red blood cells / 45(59) / 17(71) / .3
Total fresh frozen plasma / 30(39) / 10(42) / .8
Total platelets / 40(53) / 15(63) / .4
Any transfusion / 50(66) / 19(79) / .2
Outcomes
Deep sternal wound infection / 76 / 0(0) / 24 / 0(0) / >.9
Septicemia / 76 / 2(2.6) / 24 / 3(13) / .09
Permanent stroke / 76 / 4(5.3) / 24 / 1(4.2) / >.9
Reoperation for
bleeding/tamponade / 76 / 1(1.3) / 24 / 2(8.3) / .14
Atrial fibrillation / 68 / 27(40) / 20 / 9(45) / .7
Renal failure requiring dialysis / 74 / 1(1.4) / 23 / 0(0) / >.9
Prolonged ventilation (>24 h) / 58 / 15(26) / 19 / 3(16) / .5
Hospital death / 76 / 0(0) / 24 / 2(8.3) / .06
Pneumonia / 76 / 4(5.3) / 24 / 1(4.2) / >.9
Urinary tract infection / 76 / 1(1.3) / 24 / 0(0) / >.9
Central line infection / 76 / 3(3.9) / 24 / 2(8.3) / .6
Length of stayb / 76 / 24
ICU (h) / 24/62/163 / 24/48/468 / .9
Hospital (d) / 6.3/11/23 / 6.0/9.6/36 / .6
a. Patients with data available.
b.15th/50th/85th percentiles.
CLL=chronic lymphocytic leukemia; SD=standard deviation.
APPENDIX E1: VARIABLES USED IN ANALYSES
Demographics
Sex*, race*, age* (y), weight (kg), height (cm)*, body mass index (kg/m2), body surface area (m2)*
Symptoms
New York Heart Association functional class*
Ventricular function
Myocardial infarction*
Pathology
Aortic valve regurgitation*, mitral valve regurgitation*, aortic valve stenosis*, mitral valve stenosis*, pulmonary valve regurgitation*
Coronary artery disease
Number of systems diseased, left circumflex coronary artery >70% stenosis*, left anterior descending coronary artery >70% stenosis*, right coronary artery >70% stenosis, left main trunk >70% stenosis*
Cardiac comorbidity
Heart failure*, endocarditis*, atrial fibrillation*, ventricular arrhythmia, prior cardiovascular surgery, complete heart block or pacer*, number of prior cardiac operations
Noncardiac comorbidity
Bilirubin (mg/dL)*, creatinine (mg/dL)*, creatinine clearance (mL/min),blood urea nitrogen (mg/dL), hematocrit (%)*, total cholesterol (mg/dL), low-density lipoprotein cholesterol (mg/dL)*, high-density lipoprotein cholesterol (mg/dL)*, triglycerides, glomerular filtration rate, history of smoking, diabetes (insulin and non-insulin treated), pharmacologically treated diabetes*, chronic obstructive pulmonary disease*, hypertension*, dialysis, stroke*, peripheral arterial disease*
Surgical procedure details
Coronary artery bypass grafting*, aortic valve*, mitral valve*, aortic root*, atrial fibrillation*, intended incision (full)*
Coronary artery bypass grafting details
Location (left circumflex territory*, left anterior descending coronary artery*), conduit (saphenous vein*)
Missing variable indicators
Low-density lipoprotein cholesterol*
Experience
Interval: 5/1/1995 to index operation
______
*Included in propensity model.