Predictors and outcomes of cardiac complications following elective coronary bypass grafting.
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.
Charlson
M
M
Department of Medicine, Weill Medical College, Cornell University, New York, NY 10021, USA.
Krieger
K H
KH
Peterson
J C
JC
Hayes
J
J
Isom
O W
OW
D000368:Aged; D002303:Cardiac Output, Low / Q000453:epidemiology / Q000209:etiology; D002317:Cardiovascular Agents / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004232:Diuretics / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced / Q000379:methods; D006331:Heart Diseases / Q000453:epidemiology* / Q000209:etiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007430:Intraoperative Care; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D009518:New York / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011300:Preoperative Care; D011379:Prognosis; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000453:epidemiology / Q000209:etiology; D012128:Respiratory Distress Syndrome / Q000453:epidemiology / Q000209:etiology; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D004232:Diuretics