title: Coronary bypass surgery: what is changing? Analysis of 3834 patients undergoing primary isolated myocardial revascularization.
abstract: OBJECTIVE
  The patient population undergoing myocardial revascularization has changed during the last few years. Knowledge of these changes, and of the subsequent influence on morbidity and/or mortality is important, not only for up-dating quality control, but also to support decision-making in financial and economical aspects, and in further research concerning coronary artery surgery.
  
  
  METHODS
  Pre-, per- and postoperative data of 3834 primary isolated coronary bypass operations, January 1987 December 1995 were analyzed. The total group was divided into three time cohorts. Group A: 1987 1989 (n = 1292); group B: 1990-1992 (n = 1130); and group C: 1993-1995 (n = 1412).
  
  
  RESULTS
  Mean age increased from 60.4 +/- 9.0 (S.D.) years in group A to 62.9 +/- 9.9 (S.D.) years in group C (P < 0.0005). Patients with insulin-dependent diabetic (P = 0.005), uro-nefrological (P = 0.002), pulmonary (P < 0.0005)and neurological (P = 0.003) pathology increased significantly, and there was a significant increase in the use of arterial grafts (P < 0.05). Postoperative, hospital mortality remained stable (+/- 2.5%). However, there was a significant increasing percentage of patients with pulmonary (P = 0.04), neurological (P = 0.02) and uro-nefrological (P < 0.0005) problems.
  
  
  CONCLUSIONS
  During the last few years there has been a trend in myocardial revascularization of older patients, with more coexisting disease. Despite the fact that hospital mortality seems stable, there is an increase in major postoperative morbidity.
authors.affiliation: Department of Thoracic and Cardiac Surgery, University Hospital Nijmegen, Netherlands. L.Noyez@thchir.azn.nl
authors.forename: L
authors.initials: L
authors.lastname: Noyez
authors.forename: D P
authors.initials: DP
authors.lastname: Janssen
authors.forename: J A
authors.initials: JA
authors.lastname: van Druten
authors.forename: S H
authors.initials: SH
authors.lastname: Skotnicki
authors.forename: L K
authors.initials: LK
authors.lastname: Lacquet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies