Long-term outcome when major complications follow coronary artery bypass graft surgery. Recovery after complicated coronary artery bypass graft surgery.
OBJECTIVE
To determine whether information available 1 week after surgery correlates with long-term function in patients who suffer major complications after coronary artery bypass graft (CABG) surgery.


METHODS
An inception cohort study.


METHODS
A 526-bed community teaching hospital.


METHODS
All 67 patients who required at least 7 days of CT-ICU care following 2,751 consecutive CABG operations.


RESULTS
Hospital survival, long-term survival, and functional ability at long-term follow-up.


RESULTS
Forty-three patients survived hospitalization (64%), while 24 died 37 +/- 45 days (range, 7 to 190 days) after surgery. When 42 patients were surveyed 22 +/- 9 months after surgery, 21 of the survivors enjoyed excellent, independent function, 7 were moderately impaired but living at home, 6 were institutionalized with severe limitations, and 8 had died. Patients with very severe cardiac or neurologic dysfunction 1 week after surgery had an extremely poor outcome. When mechanical ventilation was required for causes other than primary failure of the respiratory system, long-term function and hospital survival were poor. Twelve of 14 patients with pulmonary complications survived hospitalization, and all 12 were alive at long-term follow-up.


CONCLUSIONS
More than half of patients requiring 7 days or more of ICU treatment after CABG surgery survive, and many enjoy excellent long-term function. However, those with very severe cardiac or neurologic dysfunction 1 week after surgery have little chance for independent recovery.
Wahl
G W
GW
University of Rochester School of Medicine and Dentistry, NY, USA.
Swinburne
A J
AJ
Fedullo
A J
AJ
Lee
D K
DK
Bixby
K
K
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002303:Cardiac Output, Low / Q000209:etiology; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007423:Intra-Aortic Balloon Pumping; D008171:Lung Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D009422:Nervous System Diseases / Q000209:etiology; D012121:Respiration, Artificial; D012189:Retrospective Studies; D015996:Survival Rate