Why the study?
What are the short-term mortality predictors and long-term survival outcomes of emergency CABG in patients with ischemic heart disease?
What are the short-term mortality predictors and long-term survival outcomes of emergency CABG in patients with ischemic heart disease?
Although emergency CABG carries a high operative mortality, patients who survive the surgery have a favorable long-term prognosis with good functional status.
High operative mortality in emergency CABG warrants caution in selection; leaves open predictors of survival for prospective validation.
During a 20-year period, 364 patients underwent coronary artery bypass grafting (CABG) for the treatment of ischemic heart disease. Among these patients, 28 underwent emergency surgery. The reasons for performing emergency CABG were unstable angina in 15 patients, impending myocardial infarction in 12 patients and congestive heart failure in 1 patient. Eleven patients died postoperatively. Eight variables were examined by univariate analysis for their influence on the occurrence of a hospital death. Lack of a history of myocardial infarction, intraaortic balloon pumping (IABP) and acute coronary occlusion were all found to be predictors of hospital death. Seventeen patients were followed up for 12 years. There was no cardiac death and actuarial survival at 12 years was 63%. The 14 survivors are now in NYHA functional class I or II. Although the operative mortality rate is high after emergency CABG, a fair prognosis can be expected if the patients survive surgery.
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Murakami et al. (1996) studied this question.
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