Factors affecting mortality after coronary bypass surgery: a scoping review
Sean Christopher Hardiman1, Yuri Fabiola Villan Villan2, Jillian Michelle Conway3
1School of Population and Public Health, University of British Columbia, 828 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada. sean.hardiman@alumni.ubc.ca.
Journal of Cardiothoracic Surgery
|March 22, 2022
Summary
This study mapped factors of in-hospital mortality after coronary artery bypass graft surgery. Most factors were patient-related, with few identified in care structures or processes, limiting quality improvement interventions.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
- Quality Improvement Science
Background:
- Numerous factors influencing post-operative mortality in coronary artery bypass graft (CABG) surgery exist.
- Existing evidence lacks mapping to a conceptual framework for care improvement, hindering targeted interventions.
Purpose of the Study:
- To identify and categorize factors associated with in-hospital mortality after isolated CABG surgery.
- To map these factors using the augmented Donabedian framework for quality of care.
Main Methods:
- Systematic review of studies published between 2000-2019 in PubMed, CINAHL, and EMBASE.
- Inclusion of adult patients (>19 years) undergoing isolated CABG surgery.
- Categorization of identified mortality factors by case-mix, structure, process, and intermediary outcomes.
Main Results:
- 52 factors from 83 articles were analyzed.
- Case-mix factors (patient characteristics, preoperative health) were most frequently reported (37 articles, 27 factors).
- Factors related to care processes (12 factors) and structures (6 factors) were less frequently reported.
Conclusions:
- Limited reporting on structural and process-related factors hinders quality improvement efforts.
- There is a need for more research on modifiable care elements to reduce mortality variation post-CABG.
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