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Published on: November 19, 2019
[Risk factors associated with 10-year survival after coronary artery bypass grafting]
Roberto González L1, Andrés Schaub C2, Felipe Alarcón O2
1Centro Cardiovascular, Hospital Clínico Regional de Concepción "Dr. Guillermo Grant Benavente", Concepción, Chile.
Insights
Ten-year survival after coronary artery bypass grafting (CABG) was comparable to international benchmarks. Key factors impacting long-term survival in CABG patients included chronic kidney disease, COPD, and diabetes mellitus.
Area of Science:
- Cardiovascular Surgery
- Public Health
- Outcomes Research
Context:
- Coronary artery bypass grafting (CABG) is a primary intervention for coronary artery disease.
- Assessing long-term outcomes is crucial for patient management and healthcare planning.
Purpose:
- To evaluate the global survival rates of patients undergoing isolated CABG.
- To identify factors associated with diminished long-term survival in this patient cohort.
Summary:
- A cohort of 658 patients undergoing isolated CABG between 2006-2008 was analyzed with a 10-year follow-up.
- Overall 10-year survival was 76%, with operative mortality at 2%.
- Significant predictors of lower long-term survival included chronic kidney disease on hemodialysis, COPD, peripheral arterial occlusive disease, and diabetes mellitus.
Impact:
- The study provides essential data on the long-term efficacy of CABG in a real-world clinical setting.
- Identified risk factors can inform pre-operative risk stratification and post-operative care strategies.
- Findings support the comparison of outcomes with international standards, aiding quality improvement initiatives.
Background:
Coronary artery bypass grafting (CABG) is the treatment of choice for a broad spectrum of patients with coronary disease.
Aim:
To describe global survival and factors associated with lower long-term survival in patients operated with isolated CABG.
Material And Methods:
Analysis of a cohort of patients who underwent CABG between January 2006 and December 2008 at a public hospital. The database and operation records of 1.003 cardiac surgeries were reviewed. Of these, an isolated CABG was performed in 658 patients aged 62 ± 9 years including 516 male (78%). Survival data were obtained from the Chilean Civil Registry Office and a complete ten-year follow up was accomplished. Survival was analyzed with Kaplan-Meier method with log-rank test and Cox regression.
Results:
Operative mortality occurred in 13 patients (2%). Survival at 1, 3, 5 and 10 years was 97, 94, 91 and 76%, respectively. One, 3, 5 and 10-year free of cardiovascular death survival was 98, 97, 95 y 89%, respectively. Factors associated with long-term survival were chronic kidney disease in hemodialysis (Hazard ratio (HR) 7.9; 95% confidence intervals (CI) 4.6-13.6), chronic obstructive pulmonary disease (HR 2.3; 95% CI 1.4-3.7), chronic arterial occlusive disease (HR 2.2; 95% CI 1.4-3.4) and diabetes mellitus (HR 1.9; 95% CI 1.4-2.6). According to EuroSCORE, 10-year survival was 86, 75 and 62% (p < 0.01) in low, medium and high-risk patients, respectively.
Conclusions:
These patients had a 10-year survival comparable to large international series. Groups associated with lower 10-year survival were identified.
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