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The occurrence of adverse events in relation to time after registration for coronary artery bypass surgery: a

Boris G Sobolev1, Guy Fradet, Lisa Kuramoto

  • 1The University of British Columbia, 828 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada. boris.sobolev@ubc.ca

Journal of Cardiothoracic Surgery
|April 13, 2013
PubMed

Insights

Longer wait times for coronary artery bypass grafting (CABG) increase the risk of death, even with similar overall death rates. Nonurgent patients face a higher cumulative incidence of preoperative death due to extended delays.

Area of Science:

  • Cardiovascular Surgery
  • Health Services Research
  • Patient Outcomes

Background:

  • Adverse events during the waiting period for coronary artery bypass grafting (CABG) are a significant concern.
  • Understanding the impact of delays on patient outcomes is crucial for optimizing surgical waitlists.

Purpose of the Study:

  • To evaluate the effect of waiting time delays on adverse events in patients awaiting coronary artery bypass grafting (CABG).

Main Methods:

  • An observational, prospective study followed 12,030 patients on a waitlist for first-time isolated CABG between 1992 and 2005.
  • Data were collected from a population-based registry, tracking patients from waitlist registration to surgery, death, or emergency surgery.

Main Results:

  • The nonurgent group experienced a greater cumulative incidence of preoperative death compared to the semiurgent group, despite similar overall death rates.
  • While the nonurgent group had a lower emergency surgery rate, longer wait times offset this, resulting in a similar cumulative incidence of emergency surgery for both groups.
  • 104 deaths and 382 emergency surgeries occurred before planned CABG.

Conclusions:

  • Extended waiting times for CABG, particularly for nonurgent cases, lead to a higher cumulative risk of preoperative death.
  • The benefits of potentially lower emergency surgery rates in nonurgent groups are diminished by longer waitlist durations.
  • Waitlist management strategies should consider the cumulative impact of delays on patient mortality and emergency surgical needs.
Abstract

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