Key result
Patients undergoing CABG in 2001/02 had worse clinical profiles than those in 1991/92, yet surgical mortality rates were similar between the two periods (1.9% vs 3.3%).
Why the study?
How did the clinical profile and post-operative mortality of patients undergoing CABG change between 1991/92 and 2001/02?
Cohort (n=307)
How did the clinical profile and post-operative mortality of patients undergoing CABG change between 1991/92 and 2001/02?
Absolute Event Rate: 1.9% vs 3.3%
The clinical profile of patients undergoing CABG worsened over a 10-year period, but post-operative mortality remained stable.
Stable CABG mortality despite sicker patients over time; leaves open whether perioperative improvements drove this in observational cohorts.
Introduction: The improvement in care and management of ischemic heart disease and the dissemination of percutaneous coronary intervention (PCI) changed the indications for coronary artery bypass grafting (CABG), regarding the procedure for multiarterial diseased patients with worse clinical conditions. Objective: To compare CABG patients surgical and clinical profiles between two groups with a 10 year interval. Evaluate post-operative mortality and severity risk scores. Method: Retrospective Cohort study, including 307 CABG patients operated in 1991/92 (n=153) and 2001/02 (n=154). Demographic characteristics, heart disease severity, comorbidities and pre-operative events were evaluated and compared between groups. Results: Patients operated in 2001/02 were older, more severe (worse NYHA class, prevalence of heart failure, and multiarterial diseased) and with more comorbidities. Patients operated in 1991/92 had more urgent procedures. The observed surgical mortality rates were similar (3,3% and 1,9%, respectively). Conclusion: Patients submitted to CABG currently are older and in worse clinical conditions than those operated 10 years ago, but hospital mortality wasn't altered significantly.
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Feier et al. (2005) conducted a cohort in Ischemic heart disease requiring CABG (n=307). CABG in 2001/02 vs. CABG in 1991/92 was evaluated on Surgical mortality. Patients undergoing CABG in 2001/02 had worse clinical profiles than those in 1991/92, yet surgical mortality rates were similar between the two periods (1.9% vs 3.3%).
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