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Published on: March 27, 2018
Preoperative prediction of early mortality in patients with low ejection fraction undergoing coronary artery bypass
Mohamed A Soliman Hamad1, Albert H M van Straten, André A J van Zundert
1Department of Cardio-thoracic Surgery, Catharina Hospital, Brabant Medical School, Eindhoven, The Netherlands. aasmsn@cze.nl
Insights
Predicting early mortality in patients with low ejection fraction (EF) undergoing coronary artery bypass grafting (CABG) is crucial. This study identified age, COPD, prior CABG, NYHA class, emergency surgery, serum creatinine, and hemoglobin as independent risk factors.
Area of Science:
- Cardiology
- Cardiac Surgery
- Clinical Research
Background:
- Patients with low ejection fraction (EF) undergoing coronary artery bypass grafting (CABG) face increased mortality and morbidity risks.
- Identifying preoperative predictors of early mortality is essential for risk stratification and patient management.
Purpose of the Study:
- To identify significant preoperative predictors of early mortality in patients with low ejection fraction (EF) undergoing isolated coronary artery bypass grafting (CABG).
Main Methods:
- A retrospective analysis of 413 patients with EF ≤ 30% who underwent isolated CABG between 1998 and 2008.
- Logistic regression analysis was employed to identify significant preoperative risk factors for early mortality.
Main Results:
- Early mortality in this patient group was 9.1%.
- Univariate and multivariate analyses identified age, chronic obstructive pulmonary disease (COPD), prior CABG, New York Heart Association (NYHA) class, emergency operation, preoperative serum creatinine (SeCr), and preoperative hemoglobin (Hb) level as independent predictors of early mortality.
Conclusions:
- The study confirms known preoperative risk factors impacting early outcomes in low EF patients undergoing CABG.
- Preoperative serum creatinine and hemoglobin levels are identified as novel predictive factors for early mortality in this population.
Background And Aim Of The Study:
Patients with low ejection fraction (EF) undergoing coronary artery bypass grafting (CABG) usually have a higher incidence of mortality and morbidity. In this retrospective study, we sought to detect significant preoperative predictors of early mortality in these patients.
Methods:
Patients with an EF of ≤ 30% who underwent isolated CABG in Catharina Hospital, Eindhoven, the Netherlands, between January 1998 and December 2008 (n = 413) were included in this study. All the preoperative patient-related risk factors were entered into a logistic regression analysis model to detect the significant predictors of early mortality.
Results:
Patients with an EF of ≤ 30% represent 4.1% of the whole CABG population. The overall early mortality in this patient group was 9.1%. Risk factors for early mortality as identified by the univariate analysis were age, chronic obstructive pulmonary disease (COPD), prior CABG, New York Heart association (NYHA) class, emergency operation, preoperative serum creatinine (SeCr), and preoperative hemoglobin (Hb) level. These factors were entered into the multivariate analysis and were all identified as independent risk factors for early mortality.
Conclusions:
This study confirmed the impact of some well-known preoperative risk factors on early outcome in patients with low EF undergoing CABG. In addition, we have shown the predictive value of preoperative SeCr and hemoglobin level that have not yet been described.
