Related Experiment Videos
Effects of seasonal variations on coronary artery surgery
Cüneyt Konuralp1, Bülend Ketenci, Batuhan Ozay
1Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiovascular Surgery, Ayse Cavus Sikak, No. 7/6, Huri Apt, Suadiye 81070, Istanbul, Turkey. ckonuralp@usa.net
Insights
Coronary artery bypass graft surgery (CABG) outcomes show no significant seasonal differences, despite higher infection and bleeding rates in summer CABG patients. This study found no impact of healthcare professional performance variations on surgical results.
Area of Science:
- Cardiovascular Surgery
- Medical Outcomes Research
- Public Health
Background:
- Coronary artery bypass graft surgery (CABG) is a common procedure.
- Seasonal variations in cardiovascular events are often reported.
- Potential impact of healthcare professional performance on surgical outcomes is a concern.
Purpose of the Study:
- To compare patient profiles and early outcomes of CABG performed in winter versus summer.
- To investigate if seasonal variations in healthcare professional performance affect CABG outcomes.
Main Methods:
- Retrospective analysis of CABG patient data from December 1998 to August 2001.
- Comparison of preoperative, perioperative, and postoperative factors between winter (Group A) and summer (Group B) cohorts.
- Analysis included demographics, comorbidities, surgical details, and postoperative complications.
Main Results:
- Preoperative demographics were similar, except for higher hypertension rates in the summer group.
- Summer CABG patients had increased rates of postoperative infection, mediastinal reexploration for bleeding, and blood transfusion.
- No significant differences were observed in early mortality rates between the two seasons.
Conclusions:
- CABG surgery outcomes do not show major seasonal variations.
- No seasonal patterns in healthcare professional performance affecting surgical outcomes were identified.
- Higher incidence of infection and bleeding observed in summer CABG patients warrants further investigation.
Background:
In this study, we compared profiles and early results of patients who underwent coronary artery bypass graft surgery (CABG) during the winter season with those who underwent CABG during the summer season. We also investigated whether possible seasonal variations in performance of health care professionals had any effects on surgical outcome.
Methods:
The data from patients who had undergone CABG surgery in the winter (group A) and summer (group B) seasons of the period from December 1998 to August 2001 were analyzed retrospectively. Preoperative, perioperative, and postoperative data were compared. Preoperative factors analyzed included sex, age, diabetes mellitus, hypertension, New York Heart Association status, unstable angina pectoris, and left ventricle ejection fraction. Perioperative factors included graft number, internal mammary artery use, cross-clamp time, and cardiopulmonary bypass time. Postoperative factors included mediastinal reexploration, blood use, inotropic support, intraaortic balloon pump support, perioperative myocardial infarctus, cardiac arrest, infection and other complications, duration of hospital stay, and early mortality.
Results:
The preoperative demographic data were identical in the 2 groups, with the exception of incidence rate of hypertension (26.8% in group A versus 15.7% in group B, P <.01). The incidence rates were higher in group B than group A for postoperative infection (8.8% versus 5.2%, P <.05), mediastinal reexploration for bleeding (6.9% versus 4.2%, P <.05), and transfusion blood use (7.3 +/- 6.2 U/patient versus 6.0 +/- 3.9 U/patient, P <.05). There were no differences between the 2 groups in early mortality rates.
Conclusion:
Despite the fact that frequency and occurrence of cardiovascular events traditionally have been reported to be higher in the winter than the summer, our data show no major differences in early surgical outcome among those patients who had undergone CABG in the winter or summer. We did not encounter any seasonal patterns. However, an interesting finding was that the patients who underwent surgery in the summer had a higher incidence of infection and bleeding.