Predictors and outcomes of cardiac complications following elective coronary bypass grafting

被引:9
作者
Charlson, M
Krieger, KH
Peterson, JC
Hayes, J
Isom, OW
机构
[1] Cornell Univ, Weill Med Coll, Div Gen Internal Med, Dept Med,Cornell Coronary Artery Bypass Outcomes, New York, NY 10021 USA
[2] Cornell Univ, Weill Med Coll, Dept Cardiothorac Surg, New York, NY 10021 USA
关键词
cardiac complications; coronary artery bypass surgery; functional status; outcomes; quality of life;
D O I
10.1046/j.1525-1381.1999.99130.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Our objective was to determine the predictors of cardiac complications among a cohort of elective coronary artery bypass graft (CABG) surgery patients and to determine the relationship of such complications to subsequent quality of life and symptoms. A total of 248 patients were enrolled and 237 completed 6 month follow-up. The combined rate of both major and minor cardiac complications was 9.7% (n = 24). patients in this study were evaluated preoperatively, monitored intraoperatively, followed immediately postoperatively and at 6 months. Major cardiac complications accounted for 3.6% (n = 9) and minor complications for 6% (n = 15). Using multivariable logistic regression analysis, the predictors of major cardiac complications were receiving diuretics preoperatively (p = .01) and increased time during cross-clamping (p = .006). At 6 months after surgery, 19% of the patients with postoperative cardiac complications experienced worsening of symptoms, in contrast to only 8% of those without cardiac complications (p = .03). We concluded that patients who were on preoperative diuretics and those who had longer cross-clamp times were at higher risk of cardiac complications. The majority of patients who had acute cardiac complications had improved function and symptoms at 6 months postoperatively.
引用
收藏
页码:622 / 632
页数:11
相关论文
共 65 条
  • [1] Alderman EL, 1997, JAMA-J AM MED ASSOC, V277, P715
  • [2] [Anonymous], 1973, Circulation, V47, P1
  • [3] PHYSICAL AND PSYCHOSOCIAL FUNCTIONING OF WOMEN AND MEN AFTER CORONARY-ARTERY BYPASS-SURGERY
    AYANIAN, JZ
    GUADAGNOLI, E
    CLEARY, PD
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1995, 274 (22): : 1767 - 1770
  • [4] PERIOPERATIVE MYOCARDIAL-INFARCTION - A DIAGNOSTIC DILEMMA
    BALDERMAN, SC
    BHAYANA, JN
    STEINBACH, JJ
    ZAKIMASUD, AR
    MICHALEK, S
    [J]. ANNALS OF THORACIC SURGERY, 1980, 30 (04) : 370 - 377
  • [5] MYOCARDIAL-INFARCTION AS A COMPLICATION OF CORONARY BYPASS SURGERY
    BREWER, DL
    BILBRO, RH
    BARTEL, AG
    [J]. CIRCULATION, 1973, 47 (01) : 58 - 64
  • [6] BRUNWALD EG, 1988, HEART DIS, P572
  • [7] BURTON JR, 1981, J THORAC CARDIOV SUR, V82, P758
  • [8] CORONARY-ARTERY BYPASS-SURGERY
    CAMERON, EWJ
    WALKER, WS
    [J]. BRITISH MEDICAL JOURNAL, 1990, 300 (6734) : 1219 - 1220
  • [9] USE OF SURVIVAL ANALYSIS TO DETERMINE THE CLINICAL-SIGNIFICANCE OF NEW Q-WAVES AFTER CORONARY-BYPASS SURGERY
    CHAITMAN, BR
    ALDERMAN, EL
    SHEFFIELD, LT
    TONG, T
    FISHER, L
    MOCK, MB
    WEINS, RD
    KAISER, GC
    ROITMAN, D
    BERGER, R
    GERSH, B
    SCHAFF, H
    BOURASSA, MG
    KILLIP, T
    [J]. CIRCULATION, 1983, 67 (02) : 302 - 309
  • [10] LONG-TERM PROGNOSIS AFTER PERIOPERATIVE CARDIAC COMPLICATIONS
    CHARLSON, M
    PETERSON, J
    SZATROWSKI, TP
    MACKENZIE, R
    GOLD, J
    [J]. JOURNAL OF CLINICAL EPIDEMIOLOGY, 1994, 47 (12) : 1389 - 1400