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Published on: March 27, 2018
In-hospital mortality of patients with severe left ventricular dysfunction undergoing coronary artery bypass grafting
Ahmadali Khalili1, Mehran Rahimi1, Naser Khezerlouy-Aghadam1
1Cardiovascular Research Center, Tabriz University of Medical Sciences, Daneshgah Street, Tabriz, Eastern Azerbaijan, Iran.
Insights
Coronary artery bypass grafting (CABG) in patients with severe heart failure showed a 9.5% mortality rate in Iran. While age, female sex, diabetes, and renal failure were linked in univariate analysis, no independent predictors of mortality were found in multivariate analysis.
Area of Science:
- Cardiology
- Cardiac Surgery
- Public Health
Background:
- Coronary artery bypass grafting (CABG) historically presents higher mortality in severe heart failure patients.
- Assessing in-hospital mortality and risk factors for CABG in Iranian patients with severe heart failure is crucial.
Purpose of the Study:
- To evaluate the in-hospital mortality rate of CABG in patients with severe heart failure in Iran.
- To identify factors associated with adverse outcomes in this patient population.
Main Methods:
- Retrospective descriptive study of 865 patients undergoing CABG from 2015-2020.
- Data collected from Madani Hospital, Tabriz University of Medical Sciences.
- Univariate and multivariate analyses were performed to identify mortality predictors.
Main Results:
- Overall in-hospital mortality was 9.5%.
- Univariate analysis identified age, female sex, diabetes mellitus (DM), and renal failure as predictors of ICU mortality (P < 0.05).
- Multivariate analysis did not identify any independent predictors of ICU mortality.
Conclusions:
- Despite reported low mortality for CABG in severe heart failure, some centers experience higher rates.
- Identifying associated risk factors and optimizing pre- and postoperative management are key to improving outcomes.
- Further research is needed to understand and mitigate mortality in this high-risk group.
Background:
Historically, coronary artery bypass grafting is associated with a higher mortality rate in patients with severe heart failure. This study aimed to assess the in-hospital mortality of CABG in patients with severe heart failure in Iranian patients and to identify factors associated with adverse outcomes.
Methods:
This retrospective descriptive study enrolled patients with severe heart failure who underwent coronary artery bypass surgery from 2015 to 2020 in Madani Hospital, affiliated with Tabriz University of Medical Sciences.
Results:
A total of 865 consecutive patients with a mean age of 60.65 ± 10.00 were enrolled in the study. Of all participants, 175 were female (20.4%), and 684 were male. The overall mortality rate was 9.5%. In the univariate analysis, predictors of ICU mortality were age, female sex, DM, and renal failure (P value < 0.05). None of the factors studied was an independent predictor of ICU mortality in the multivariate analysis.
Conclusion:
This study established that although coronary artery bypass surgery is reported to have low mortality and postoperative morbidity in patients with severe heart failure, there are still centers that face higher mortality rates in these patients. Improving these patients' outcomes would be possible through identifying the associated risk factors and pre-and postoperative management.
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