CIRCADIAN RHYTHM HAS NO EFFECT ON MORTALITY IN CORONARY ARTERY BYPASS SURGERY
Autor: | Shyama Balasubramanya, Nancy Schulhoff, Joseph N. Cunningham, Murali Pagala, Ajay K. Dhadwal, Joshua H. Burack, Mikhail Vaynblat |
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Rok vydání: | 2005 |
Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Waiting Lists Preoperative risk Coronary Artery Disease Critical Care and Intensive Care Medicine Medical Records Coronary artery bypass surgery Postoperative Complications Internal medicine Humans Medicine In patient Circadian rhythm Coronary Artery Bypass Aged Retrospective Studies Morning Ejection fraction business.industry Significant difference Circadian Rhythm medicine.anatomical_structure Elective Surgical Procedures Cardiology Surgery Female New York City Emergencies Cardiology and Cardiovascular Medicine business Artery |
Zdroj: | Chest. 128:274S |
ISSN: | 0012-3692 |
DOI: | 10.1378/chest.128.4_meetingabstracts.274s |
Popis: | Background: The circadian variation that affects atherosclerosis has not been studied in the surgical patient. The circadian variation in mortality dependent on the time of surgery was examined in patients undergoing coronary artery bypass graft (CABG) surgery. Methods: A 4-year retrospective review of all CABG patients (n = 3140) from 1999 to 2002 was undertaken. The patients were divided into elective, urgent, and emergency cases. The cases were subdivided according to the start time of the operation as morning (7 AM to 2 PM = AM), afternoon (2 PM to 8 PM = AF), and night (8 PM to 7 AM = NT). The outcome was mortality within 30 days and compared for three different time frames: (1) AM versus AF (2) AM versus NT (3) AF versus NT for each prioritized group. Risk factors and number of anastamoses were compared for each group. Sigma Statistical package and Z-test for two group comparison were used for analysis. t-Test was used to compare age and ejection fraction. Results: No statistically significant difference in mortality was observed for the elective and urgent groups for each of the time periods compared. The emergency cases had significantly increased deaths in the AM and NT compared to the AF (p < 0.01 and p < 0.05, respectively). There was no statistically significant difference with respect to age, gender, number of anastamoses performed, ejection fraction, and preoperative risk factors between groups. Conclusions: The mortality for nonemergent CABG is independent of the timing of surgery. Circadian variation does not influence the outcome in cardiac surgical patients. |
Databáze: | OpenAIRE |
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