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Mortality in the first year after coronary artery bypass surgery. Irish Cardiac Surgery Register
1Department of Community Medicine and Epidemilogy, University Colleg Dublin.
Insights
This study of 1,534 patients undergoing coronary artery bypass grafting (CABG) found operative mortality was 3.4%. Key risk factors for death included advanced age and poor heart function.
Area of Science:
- Cardiology
- Cardiac Surgery
- Public Health
Background:
- The Irish Cardiac Surgery Register (ICSR) collected data from 1983-1985.
- This dataset represents all primary isolated coronary artery bypass grafting (CABG) procedures in Ireland.
- It offers insights into diverse clinical subgroups with ischemic heart disease.
Purpose of the Study:
- To analyze operative and one-year mortality following coronary artery bypass grafting (CABG).
- To identify prognostic indicators for operative and late mortality in CABG patients.
Main Methods:
- Retrospective analysis of 1,534 primary isolated CABG cases recorded by the ICSR.
- Statistical analysis to determine factors associated with operative and one-year mortality.
Main Results:
- Operative mortality was 3.4% (52 deaths), rising to 4.9% (75 deaths) at one year.
- Factors linked to operative mortality included female sex, age >60, left ventricular failure, recent myocardial infarction, poor left ventricular function, and extensive coronary disease.
- All factors except female sex predicted one-year mortality. Pre-operative impaired left ventricular function was a significant indicator for late deaths (1.5%).
Conclusions:
- Several pre-operative factors significantly impact short-term and one-year survival after CABG.
- Impaired left ventricular function is a critical predictor of long-term outcomes in patients undergoing CABG.
Abstract:
In the three years 1983-1985 the Irish Cardiac Surgery Register (ICSR) recorded details on 1,534 patients who underwent primary isolated coronary artery bypass grafting (CABG). This unselected series of patients accounted for all such operations in the Republic of Ireland during this period and provides information on a wide spectrum of clinical subgroups of patients with ischaemic heart disease. There were 52 operative deaths (3.4%). At one year the number of deaths had risen to 75 (4.9%). Factors related to operative mortality were female sex, age greater than 60, left ventricular failure, history of myocardial infarction in the six weeks prior to surgery, poor left ventricular function and extensive disease of vessels to be grafted. All of the above factors except female sex were related to one year mortality. Analysis of late deaths (1.5%) separately showed evidence of pre-operative impaired left ventricular function to be an important prognostic indicator.