Repositorio
Institucional

Lozada-Ramos, Heiler

Daza-Arana, Jorge E.

Gonzalez, Mauricio Zarate

Gallo, Luis F. Medina

Lanas, Fernando

Risk factors for in-hospital mortality after coronary artery bypass grafting in Colombia

EDIZIONI MINERVA MEDICA

JOURNAL OF CARDIOVASCULAR SURGERY

en

BACKGROUND: 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. METHODS: 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. RESULTS: 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 age >75 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). CONCLUSIONS: This study identifies the factors during preoperative and intraoperative periods that are associated with in-hospital mortality in patients that have undergone CABG.

artículo original

10.23736/S0021-9509.21.11829-4

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Coronary artery bypass

Mortality

Risk factors

Social class

CLINICAL CHARACTERISTICS

MYOCARDIAL-INFARCTION

OPERATIVE MORTALITY

CARDIOGENIC-SHOCK

SURGERY

OUTCOMES

SOCIETY

EUROSCORE

MODELS

Sistemas cardíacos y cardiovasculares

Cirugía

Enfermedad vascular periférica

Bypass de arteria coronaria

Mortalidad

Factores de riesgo

Clase social

CARACTERÍSTICAS CLÍNICAS

INFARTO DE MIOCARDIO

MORTALIDAD OPERATORIA

SHOCK CARDIOGÉNICO

CIRUGÍA

RESULTADOS

SOCIEDIA

EUROSCORE

MODELOS

Sistema Cardiovascular y Cardiaco

Cirugía

Medicina de Emergencia y de Cuidados Críticos

Risk factors for in-hospital mortality after coronary artery bypass grafting in Colombia

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