Long-term survival and prognostic implications after coronary artery bypass grafting in Chinese patients with coronary artery disease.
OBJECTIVE
This hospital-based study was conducted to determine the survival rates of patients after coronary artery bypass grafting (CABG) surgery and the associated prognostic factors related to all-cause mortality during a 7-year follow-up in Taiwan.


RESULTS
Between January 1997 and December 2003, the medical records of 1877 patients who underwent primary, isolated CABG surgery were studied. The Kaplan-Meier method was used to estimate survival. Multiple Cox regression was used to investigate the independence of prognostic factors associated with all-cause mortality. Of the 1877 patients who underwent CABG surgery, 192 expired during the 7-year study period. The overall patient survival rate was 85.96% (95% CI: 83.74-88.16). Using multiple Cox regression analysis, in addition to female gender, older age at surgery, pulmonary oedema, longer ischaemic time, longer cardiopulmonary bypass time, and poorer postoperative left ventricular ejection fraction were significant factors associated with all-cause mortality for both men and women. Associated prognostic factors varied by gender. For men, smoking (RR = 2.82, 95% CI: 1.06-4.16), respiratory failure (RR = 6.88, 95% CI: 3.29-14.40) and cardiogenic shock (RR = 4.04, 95% CI: 2.13-7.67) were significantly related to all-cause mortality, but not for women. Sepsis (RR = 8.97,95% CI: 1.19-19.81) and ICU stay (RR = 1.03,95% CI: 1.01-1.05) were significantly related to all-cause mortality among female patients only.


CONCLUSIONS
Several gender-related differences were noted pertaining to all-cause mortality and the relationships between smoking, sepsis, respiratory failure, cardiogenic shock, and ICU stay.
Hsiung
Ming C
MC
Division of Cardiology, Department of Medicine , Cheng-Hsin General Hospital, Taipei, Taiwan.
Wei
Jeng
J
Chang
Chung-Yi
CY
Chuang
Yi-Cheng
YC
Lee
Kuo-Chen
KC
Sue
Sung-How
SH
Chou
Yi-Pen
YP
Hsiung
Richard
R
Shih
Hui-Chuan
HC
Huang
Chien-Ming
CM
Yin
Wei-Hsian
WH
Young
Mason S
MS
Tung
Tao-Hsin
TH
D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D002315:Cardiopulmonary Bypass; D050377:Cold Ischemia; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007036:Hypothermia, Induced; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012107:Research Design; D012307:Risk Factors; D012737:Sex Factors; D013318:Stroke Volume; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome