Why the study?
What are the predictors of cardiac complications following elective CABG and how do they affect symptoms at 6 months?
What are the predictors of cardiac complications following elective CABG and how do they affect symptoms at 6 months?
Preoperative diuretic use and longer cross-clamp times are significant predictors of cardiac complications after elective CABG, which in turn are associated with worse symptoms at 6 months.
Preoperative diuretics and longer cross-clamp time may flag higher-risk CABG patients; hypothesis-generating for 6-month symptoms, needs prospective validation.
Our objective was to determine the predictors of cardiac complications among a cohort of elective coronary artery bypass graft (CABG) surgery patients and to determine the relationship of such complications to subsequent quality of life and symptoms. A total of 248 patients were enrolled and 237 completed 6 month follow‐up. The combined rate of both major and minor cardiac complications was 9.7% (n = 24). Patients in this study were evaluated preoperatively, monitored intraoperatively, followed immediately postoperatively and at 6 months. Major cardiac complications accounted for 3.6% (n = 9) and minor complications for 6% (n = 15). Using multivariable logistic regression analysis, the predictors of major cardiac complications were receiving diuretics preoperatively (p = .01) and increased time during cross‐clamping (p = .006). At 6 months after surgery, 19% of the patients with postoperative cardiac complications experienced worsening of symptoms, in contrast to only 8% of those without cardiac complications (p = .03). We concluded that patients who were on preoperative diuretics and those who had longer cross‐clamp times were at higher risk of cardiac complications. The majority of patients who had acute cardiac complications had improved function and symptoms at 6 months postoperatively.
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Charlson et al. (1999) studied this question.
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