Effect of Prior Cardiac Operations on Survival After Coronary Artery Bypass Grafting
| Autor: | David J. Malenka, Bruce J. Leavitt, Gerald L. Sardella, Donald S. Likosky, Francis V. DiPierro, Robert E. Helm, Louis Russo, Meredith J. Sorensen, Todd A. MacKenzie, Jeremiah R. Brown, Yvon R. Baribeau, Stephen D. Surgenor, Robert S. Kramer, Cathy S. Ross |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Cardiac output Time Factors Bypass grafting Coronary Artery Disease Kaplan-Meier Estimate Risk Assessment New England Risk Factors Internal medicine medicine Humans Hospital Mortality Postoperative Period Prospective Studies Cardiac Surgical Procedures Coronary Artery Bypass Propensity Score Survival analysis Aged Aged 80 and over business.industry Inverse probability weighting Hazard ratio Middle Aged Confidence interval Surgery Survival Rate Cardiac operations medicine.anatomical_structure Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies Artery |
| Zdroj: | The Annals of Thoracic Surgery. 92:1260-1267 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2011.05.111 |
| Popis: | Background We examined a recent regional experience to determine the effect of a prior cardiac operation on short-term and midterm outcomes after coronary artery bypass grafting (CABG). Methods We identified 20,703 patients who underwent nonemergent CABG at 8 centers in northern New England from 2000 to 2008, of whom 818 (3.8%) had undergone prior cardiac operations. Prior CABG using a minimal or full sternotomy was considered a prior sternotomy. Survival data out to 4 years were obtained from a link with the Social Security Administration Death Index. Hazard ratios were estimated using a Cox proportional hazards regression model, and adjusted survival curves were estimated using inverse probability weighting. In a separate analysis, 1,182 patients were matched 1:1 by a patient's propensity for having undergone prior CABG. Results Patients with prior sternotomies had a greater burden of comorbid diseases and increased acuity and had a greater likelihood of returning to the operating room for bleeding and low cardiac output failure. Prior sternotomy was associated with an increased risk of death out to 4 years for patients undergoing CABG, with an unmatched hazard ratio of 1.34 (95% confidence interval, 1.10 to 1.64) and a matched hazard ratio of 1.36 (95% confidence interval, 1.01 to 1.81). Conclusions Analyses of our recent regional experience with nonemergent CABG showed that a prior cardiac operation was associated with a nearly twofold increased hazard of death at up to 4 years of follow-up. |
| Databáze: | OpenAIRE |
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