Determinants of operative mortality following primary coronary artery bypass surgery

Navid Sadeghi, Sarmad Sadeghi, Zhoobin Abbasi Mood, Abbasali Karimi

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: The purpose of this study was to determine the factors which can help to predict operative mortality before performing the operation, and afterwards. Methods: The study population consisted of 504 patients (91 women and 413 men) who underwent primary isolated coronary artery bypass surgery from December 1997 to September 1999 by the same surgeon in a referral center in Tehran, Iran. Perioperative data were gathered and analyzed both in a univariate and multivariate model. Results: After the operation patients spent 7.3±4.0 days in hospital. The total operative morbidity was 20.5%. Arrhythmias were the most common complication, with atrial fibrillation as the predominant feature. Major complications of the operation were: low cardiac output (4.2%); prolonged ventilatory support (2.4%); hemorrhage and exploratory reoperation (2.0%); postoperative myocardial infarction (1.4%); postoperative renal failure in (1.4%); and postoperative cerebrovascular accident (0.8%). Operative mortality rate in this study was 2.98%. Factors associated with high operative mortality in univariate analysis were: recent myocardial infarction, low ejection fraction, non-elective operation, left main coronary artery disease and prolonged cardiopulmonary bypass time. Conclusion: Our data suggest that prior to operation, operative mortality can be best predicted by urgency of operation and left ventricle ejection fraction. After performing the operation, prognostic factors include preoperative LVEF≤35%, non-elective operation, and prolonged cardiopulmonary bypass time. Further study is required to assess the generalization of our findings to Iranian patients.

Original languageEnglish (US)
Pages (from-to)187-192
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume21
Issue number2
DOIs
StatePublished - 2002

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Coronary Artery Bypass
Mortality
Cardiopulmonary Bypass
Myocardial Infarction
Low Cardiac Output
Iran
Reoperation
Atrial Fibrillation
Heart Ventricles
Renal Insufficiency
Cardiac Arrhythmias
Coronary Artery Disease
Referral and Consultation
Stroke
Hemorrhage
Morbidity
Population

Keywords

  • Coronary artery bypass
  • Operative mortality
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Determinants of operative mortality following primary coronary artery bypass surgery. / Sadeghi, Navid; Sadeghi, Sarmad; Mood, Zhoobin Abbasi; Karimi, Abbasali.

In: European Journal of Cardio-thoracic Surgery, Vol. 21, No. 2, 2002, p. 187-192.

Research output: Contribution to journalArticle

Sadeghi, Navid ; Sadeghi, Sarmad ; Mood, Zhoobin Abbasi ; Karimi, Abbasali. / Determinants of operative mortality following primary coronary artery bypass surgery. In: European Journal of Cardio-thoracic Surgery. 2002 ; Vol. 21, No. 2. pp. 187-192.
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abstract = "Background: The purpose of this study was to determine the factors which can help to predict operative mortality before performing the operation, and afterwards. Methods: The study population consisted of 504 patients (91 women and 413 men) who underwent primary isolated coronary artery bypass surgery from December 1997 to September 1999 by the same surgeon in a referral center in Tehran, Iran. Perioperative data were gathered and analyzed both in a univariate and multivariate model. Results: After the operation patients spent 7.3±4.0 days in hospital. The total operative morbidity was 20.5{\%}. Arrhythmias were the most common complication, with atrial fibrillation as the predominant feature. Major complications of the operation were: low cardiac output (4.2{\%}); prolonged ventilatory support (2.4{\%}); hemorrhage and exploratory reoperation (2.0{\%}); postoperative myocardial infarction (1.4{\%}); postoperative renal failure in (1.4{\%}); and postoperative cerebrovascular accident (0.8{\%}). Operative mortality rate in this study was 2.98{\%}. Factors associated with high operative mortality in univariate analysis were: recent myocardial infarction, low ejection fraction, non-elective operation, left main coronary artery disease and prolonged cardiopulmonary bypass time. Conclusion: Our data suggest that prior to operation, operative mortality can be best predicted by urgency of operation and left ventricle ejection fraction. After performing the operation, prognostic factors include preoperative LVEF≤35{\%}, non-elective operation, and prolonged cardiopulmonary bypass time. Further study is required to assess the generalization of our findings to Iranian patients.",
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AB - Background: The purpose of this study was to determine the factors which can help to predict operative mortality before performing the operation, and afterwards. Methods: The study population consisted of 504 patients (91 women and 413 men) who underwent primary isolated coronary artery bypass surgery from December 1997 to September 1999 by the same surgeon in a referral center in Tehran, Iran. Perioperative data were gathered and analyzed both in a univariate and multivariate model. Results: After the operation patients spent 7.3±4.0 days in hospital. The total operative morbidity was 20.5%. Arrhythmias were the most common complication, with atrial fibrillation as the predominant feature. Major complications of the operation were: low cardiac output (4.2%); prolonged ventilatory support (2.4%); hemorrhage and exploratory reoperation (2.0%); postoperative myocardial infarction (1.4%); postoperative renal failure in (1.4%); and postoperative cerebrovascular accident (0.8%). Operative mortality rate in this study was 2.98%. Factors associated with high operative mortality in univariate analysis were: recent myocardial infarction, low ejection fraction, non-elective operation, left main coronary artery disease and prolonged cardiopulmonary bypass time. Conclusion: Our data suggest that prior to operation, operative mortality can be best predicted by urgency of operation and left ventricle ejection fraction. After performing the operation, prognostic factors include preoperative LVEF≤35%, non-elective operation, and prolonged cardiopulmonary bypass time. Further study is required to assess the generalization of our findings to Iranian patients.

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