Use of Cardiopulmonary Bypass in High-Risk Patients Is a Predictor of Adverse Outcome
| Autor: | Nimesh D. Desai, Richard J. Novick, Alan H. Menkis, W.Douglas Boyd, F.Neil McKenzie, Dario F. DelRizzo |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
High risk patients Bypass grafting Adverse outcomes business.industry Perioperative 030204 cardiovascular system & hematology Intensive care unit law.invention Surgery 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine medicine.anatomical_structure 030228 respiratory system law medicine Cardiopulmonary bypass Risk factor Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Seminars in Cardiothoracic and Vascular Anesthesia. 4:86-91 |
| ISSN: | 1940-5596 1089-2532 |
| DOI: | 10.1053/vc.2000.6480 |
| Popis: | High-risk patients experience substantially more compli cations after coronary artery bypass grafting (CABG). We hypothesized that these patients are uniquely vulner able to cardiopulmonary bypass and compared postop erative outcomes between high-risk patients undergo ing off-pump CAB (OPCAB) and conventional CABG. Prospective provincial cardiac care registry and retro spective chart data were reviewed for 1,850 consecutive patients at our institution between January 1996 and January 1999. From this, 235 patients, 36 OPCAB and 199 CABG, were identified as high risk (modified Parson net score ≥15). Risk factor analysis showed the popula tions were equivalent in perioperative risk with mean modified Parsonnet scores of 18.1 ± 3.4 (OPCAB) and 18.7 ± 4.2 (CABG) (P = .4). In total, 6% of OPCAB and 40% of CABG patients suffered major complications leading to extended hospital/intensive care unit (ICU) stay or death ( P ≤ .001). Mean hospital stays were 7.0 ± 4.0 days (OPCAB) and 10.6 ± 10.2 days (CABG) ( P ≤ .001). Mean ICU stays were 23.9 ± 9.7 hours (OPCAB) and 64.9 ± 128.3 hours (CABG) ( P ≤ .001). Mortality was 0% in the OPCAB group and 6% in the CABG group (P = .2). Multivariate predictors of experiencing a major complication were: use of cardiopulmonary bypass (OR 5.1, 95 Cl 2.1-12.1), age > 80 (OR 2.5, 95 Cl 1.7-7.5), female (OR 3.0, 95 Cl 1.6-5.4), repeat operation (OR 2.5, 95 Cl 1.2-5.4), and ejection fraction |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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