Risk factors for in-hospital mortality after coronary artery bypass grafting in Colombia
| Autor: | Luis F. Medina Gallo, Fernando Lanas, Heiler Lozada-Ramos, Mauricio Zárate González, Jorge E. Daza-Arana |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Time Factors Coronary Artery Disease Colombia Risk Assessment Postoperative Complications Risk Factors Medicine Humans Myocardial infarction Hospital Mortality Coronary Artery Bypass Retrospective Studies business.industry Vascular disease Unstable angina Cardiogenic shock General Medicine Odds ratio medicine.disease Confidence interval Surgery Cardiac surgery Treatment Outcome Heart failure Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of cardiovascular surgery. 63(1) |
| ISSN: | 1827-191X |
| Popis: | The aim of this study was to determine the factors associated with in-hospital mortality after a coronary artery bypass (CABG) in a high-complexity clinic in the city of Santiago de Cali, Colombia.A retrospective case-control analytical study was performed. Cases were defined as adult patients that had undergone CABG and died within 30 days of the surgery. Patients aged ≥18 years that had undergone isolated surgeries were included, i.e. procedures without other interventions combined. Patients were excluded from this study if: 1) they had missing data in their medical records; 2) they had previously been in a state of coma; or 3) they had previously undergone cardiac surgery other than a bypass procedure. Exposure variables were measured at three stages: preoperative, intraoperative, and postoperative.The study included 77 cases and 308 controls. The most common cause of death was cardiogenic shock (53.2%), followed by sepsis (27.3%). The multinomial logistic regression model revealed an association of in-hospital mortality with preoperative variables of age75 years (odds ratio [OR] 2.5, 95% confidence interval [95% CI]: 1.1-5.8, P=0.032), low socioeconomic status (OR=2.3, 95% CI: 1.1-5.2, P=0.034), heart failure (HF) (OR=3.2, 95% CI: 1.5-7.0, P=0.002), unstable angina (OR=4.2, 95% CI: 1.9-9.0, P=0.000), acute myocardial infarction (AMI)≤7 days (OR=3.9, 95% CI: 1.1-13.7, P=0.037), chronic kidney insufficiency (CKI) (OR=2.9, 95% CI: 1.2-7.0, P=0.018), peripheral vascular disease (PVD) (OR=2.8, 95% CI: 1.2-6.8, P=0.019), and urgent/emergent surgery (OR=8.2, 95% CI: 2.0-34.5, P=0.004). Of the intraoperative variables, the model showed an association between the use of inotropic agents (OR=2.8, 95% CI: 1.3-6.4, P=0.011) and cardiogenic shock (OR=50.6, 95% CI: 7.5-339, P=0.000).This study identifies the factors during preoperative and intraoperative periods that are associated with in-hospital mortality in patients that have undergone CABG. |
| Databáze: | OpenAIRE |
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