Risk factors for mortality of patients undergoing coronary artery bypass graft surgery

Abstract

IntroductionCoronary artery bypass grafting is a safe procedure performed worldwide with low rates of mortality and morbidity in general population.ObjectiveTo investigate risk factors for mortality of patients undergoing coronary artery bypass grafting coronary artery bypass grafting surgery.MethodsA total of 1,628 consecutive patients undergoing on-pump coronary artery bypass grafting were retrospectively studied from December 1999 to February 2012. Data analysis involved paired Student t test, Mann-Whitney test and Fisher’s exact test for the categorical data. Logistic regression, Odds Ratio and 95%CI were used for definition of risk factors for mortality.ResultsOf a total of 1,628 patients undergoing on-pump coronary artery bypass grafting, 141 (8.7%) died. The following risk factors for mortality were identified after logistic regression: dialysis (OR=7.61; 95%CI 3.58-16.20), neurologic dysfunction type I (OR=4.42; 95%CI 2.48-7.81), use of IABP (OR=3.38; 95%CI 1.98-5.79), cardiopulmonary bypass time (OR=3.09; 95%CI 2.04-4.68), serum creatinine on admission and peak values > 0.4mg/dL (OR=2.67; 95%CI 1.79-4.00), age > 65 years (OR=2.31; 95%CI 1.55-3.44), and time between hospital admission and and surgical procedure (OR=1.53; 95%CI 1.03-2.27).ConclusionDialysis, type I neurologic dysfunction, use of IABP, cardiopulmonary bypass time (> 115 minutes), serum creatinine on admission and peak values>0.4mg/dL, age > 65 years and time between hospital admission and surgical procedure were considered as risk factors for mortality in patients undergoing on-pump coronary artery bypass grafting surgery.

Do We Need to Personalize Renal Function Assessment in the Stratification of Patients Undergoing Cardiac Surgery?

“…Nevertheless, in patients with SC ≥ 1.35 mg/dL, observed mortality was greater than expected mortality, reaching values two times greater than in patients with SC ≥ 1.60 mg/dL. Although SC has been used by Brazilian health care centers, 22 , 23 even as a criteria of ARF stage classification, 24 it should be analyzed with caution due to its lack of calibration in predicting mortality. This should start with the inclusion of CC in local risk scores, in which SC is still used as a binary data.…”

Evolução clínica de pacientes submetidos à revascularização do miocárdio em um hospital universitário de 2004 a 2008

“…A incidência de mortalidade tem sido muito estudada tanto em pesquisas clínicas, como em base de dados secundários na área cardiológica pelos riscos de morte que os portadores de doença coronariana estão sujeitos. Ainda, tem sido utilizada como indicador de qualidade de serviços e de capacidade técnica do cirurgião, contudo há uma expectativa de que o uso desse indicador seja pautado em modelos de predição de risco cirúrgico para que os índices possam ser comparados e a qualidade tenha uma lógica para sua aferição, pois os pacientes indicados para RM diferem muito em extensão da doença coronariana e complicações clínicas, bem como pela associação de outras doenças (5,7,18,(23)(24)(25). A taxa de óbito no presente estudo está em acordo com outros estudos (22), tendo a maioria ocorrido no CTI e a seguir no Centro Cirúrgico.…”

The Effect of Preoperative Hematocrit Level on Early Outcomes After Coronary Artery Bypass Surgery

“…For the last 10 years, many studies have been done to determine the surgical risk factors of CAD and preoperative risk scoring has become extremely important in patients undergoing CABG surgery. The success of surgery depends to some extent on the elimination or improvement of these factors, or on taking measures against it [3,4]. Some of these factors include advanced age, poor ventricular function, presence of diffuse coronary lesions, presence of poor respiratory or renal function, previous cardiac surgery, complicated surgery, and emergent surgical intervention.…”