Early postoperative complications after coronary artery bypass grafting at the San Juan Veterans Affairs Medical Center.
OBJECTIVE
Describe the perioperative characteristics of the patients undergoing coronary artery bypass grafting (CABG) in San Juan, Veterans Affairs Medical Center (SJ-VAMC). Determine the in-hospital and 30-day morbidity and mortality following CABG and identify adverse predictors for postoperative complications.


BACKGROUND
Preoperative risk factors for complications post-CABG have been identified; however limited data is available regarding the value of these predictors in the Puerto Rican Population.


METHODS
Perioperative characteristics and 30-day complications were gathered from all patients undergoing CABG (n = 252) at the SJ-VAMC (2001-2003). Logistic regression analysis was performed to determine factors associated with the occurrence of complications.


RESULTS
The population's mean age was 66.9 +/- 8.1 years. Associated illnesses included: hypertension (95.6%), diabetes (57%), past smoking (61%), COPD (26%), chronic renal insufficiency (CRI-11.5%), cerebrovascular disease (CVD-20.6%), disabling angina (78%), 3-vessel coronary disease (75.8%), significant left main stenosis (20%), and non-elective surgical intervention (54%). The most frequent primary complications were postoperative myocardial infarction (MI-4.8%) and congestive heart failure (4.8%). The 30-day mortality was 1.2%. Upon multivariate analysis PRBC transfusions > 3 units was associated to increased risks of primary complications, in patients with prior history of CVD. CRI and LVEF < or = 40% were independently associated to development of primary complications, in patients with prior MI and CVD.


CONCLUSIONS
The preoperative characteristics are suggestive of an older and sicker patient that is undergoing CABG at the SJ-VAMC. Despite this, the death rate was low and the frequency of other complications comparable to the Society of Thoracic Surgeons (STS) National Adult Cardiac Database.
Escabí-Mendoza
José
J
Cardiology Section, Department of Medicine, Veterans Affairs Medical Center, One Veterans Plaza, #10 Casia St, San Juan, Puerto Rico 00927-5800. Jose.Escabi@med.va.gov
Acevedo
José
J
Rucabado
Elena
E
Pérez
Cynthia M
CM
Rodríguez-Ospina
Luis
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000453:epidemiology / Q000601:surgery; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D011647:Puerto Rico / Q000453:epidemiology; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome