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

Primer Autor
Lozada-Ramos, Heiler
Co-autores
Daza-Arana, Jorge E.
Gonzalez, Mauricio Zarate
Gallo, Luis F. Medina
Lanas, Fernando
Título
Risk factors for in-hospital mortality after coronary artery bypass grafting in Colombia
Editorial
EDIZIONI MINERVA MEDICA
Revista
JOURNAL OF CARDIOVASCULAR SURGERY
Lenguaje
en
Resumen
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.
Tipo de Recurso
artículo original
doi
10.23736/S0021-9509.21.11829-4
Formato Recurso
PDF
Palabras Claves
Coronary artery bypass
Mortality
Risk factors
Social class
CLINICAL CHARACTERISTICS
MYOCARDIAL-INFARCTION
OPERATIVE MORTALITY
CARDIOGENIC-SHOCK
SURGERY
OUTCOMES
SOCIETY
EUROSCORE
MODELS
Ubicación del archivo
http://dx.doi.org/10.23736/S0021-9509.21.11829-4
Categoría OCDE
Sistemas cardíacos y cardiovasculares
Cirugía
Enfermedad vascular periférica
Materias
Bypass de arteria coronaria
Mortalidad
Factores de riesgo
Clase social
CARACTERÍSTICAS CLÍNICAS
INFARTO DE MIOCARDIO
MORTALIDAD OPERATORIA
SHOCK CARDIOGÉNICO
CIRUGÍA
RESULTADOS
SOCIEDIA
EUROSCORE
MODELOS
Disciplinas de la OCDE
Sistema Cardiovascular y Cardiaco
Cirugía
Medicina de Emergencia y de Cuidados Críticos
Título de la cita (Recomendado-único)
Risk factors for in-hospital mortality after coronary artery bypass grafting in Colombia
Página de inicio (Recomendado-único)
78
Página final (Recomendado-único)
84
Identificador del recurso (Mandatado-único)
artículo original
Versión del recurso (Recomendado-único)
version publicada
Condición de la licencia (Recomendado-repetible)
0
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Id de Web of Science
WOS:000760888400012
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