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Tabula viva chirurgic: a living surgical document
Marius J Swart1, Gina Joubert2, Jan-Albert van den Berg3
1Bloemfontein Mediclinic; Health Sciences Education, Faculty of Health Sciences, and Department of Practical Theology, Faculty of Theology, University of the Free State, Bloemfontein, South Africa.
Insights
This cardiac surgery study analyzed 1,750 coronary artery bypass graft (CABG) patients. Favorable outcomes were observed, with mortality linked to patient co-morbidities.
Area of Science:
- Cardiovascular Surgery
- Surgical Outcomes Research
Background:
- Private cardiac surgical practices are vital for patient care.
- Understanding outcomes in private practice complements large registry data.
Purpose of the Study:
- To present surgical outcomes from a private cardiac surgical practice.
- To compare observed mortality and morbidity with established benchmarks.
- To identify risk factors for postoperative death.
Main Methods:
- Statistical analysis of a personal database of 1,750 consecutive coronary artery bypass graft (CABG) patients.
- Comparison of mortality and major morbidity figures with large national/international registries.
- Stepwise logistic regression to determine independent risk factors for postoperative death.
Main Results:
- Over 12 years, 1,750 patients underwent CABG (76.8% male, 23.2% female).
- Observed mortality rate was 3.03%, compared to an expected EuroSCORE of 3.87%.
- Independent risk factors for death included urgency, renal impairment, re-operation, and additional procedures. Major complications occurred in 91 patients.
Conclusions:
- Mortality and morbidity rates were favorable compared to international registries.
- Patient co-morbidities were identified as the primary drivers of mortality.
- Findings offer insights into surgical practice and potential for enhanced surgeon understanding.
Aim:
The purpose of this article is to present the results of a private cardiac surgical practice. This information could also serve as a hermeneutical text for new wisdom.
Methods:
A personal database of 1 750 consecutive patients who had had coronary artery bypass graft (CABG) surgery was statistically analysed. Mortality and major morbidity figures were compared with large registries. Risk factors for postoperative death were determined.
Results:
Over a period of 12 years, 1 344 (76.8%) males and 406 (23.2%) females were operated on. The observed mortality rate was 3.03% and the expected mortality rate (EuroSCORE) was 3.87%. After stepwise logistic regression, independent risk factors for death were urgency (intra-aortic balloon pump), renal impairment (chronic kidney disease, stage III), re-operation and an additional procedure. Apart from the 53 deaths, another 91 patients had major complications.
Conclusion:
Mortality and morbidity rates compared favourably with other international registries. Mortality was related to co-morbidities. This outcome contributes to a hermeneutical understanding focusing on new spiritual wisdom and meaning for the surgeon.
