title: Outcome of emergency coronary artery bypass grafting.
abstract: OBJECTIVE
  The aim of this study was to evaluate the immediate and late outcome of emergency coronary artery bypass grafting (CABG) in a multicenter setting.
  
  
  METHODS
  Multicenter, retrospective study.
  
  
  METHODS
  Four university hospitals.
  
  
  METHODS
  596 patients were included in this study.
  
  
  METHODS
  Included patients underwent isolated, emergency CABG.
  
  
  RESULTS
  Sixty patients (absolute rate: 10.1%, pooled rate: 8.7%) died during the in-hospital stay period. Increasing emergency CABG classes (p<0.0001), recent myocardial infarction (p=0.019), left ventricular ejection fraction≤30% (p=0.034), on-pump surgery (p=0.012), and participating centers (p<0.0001) were independent predictors of in-hospital mortality. Survival rates at 1, 3, and 5 years were 86.4%, 81.6%, and 76.1%, respectively. Extracorporeal membrane oxygenation was used in 6 patients and 3 of them (50.0%) survived the immediate postoperative period. Patient populations of participating centers differed significantly in most of baseline characteristics. The preoperative use of intra-aortic balloon pump (8% to 51%) and off-pump surgery (2.8% to 56.3%) varied significantly between institutions. In-hospital mortality (2.8%, 5.9%, 7.7% and 19.8%, p<0.0001), as well as midterm survival, significantly differed between institutions (at 3 years, 90.6%, 89.8%, 81.2%, and 67.2%, p<0.0001).
  
  
  CONCLUSIONS
  The outcome after emergency CABG is satisfactory despite a significant operative risk. However, the results of emergency CABG significantly differed between the participating institutions, likely due to differences in the referral pathways and perioperative treatment strategies. Evaluation of these factors is crucial for implementation of treatment in centers with suboptimal results.
authors: Department of Surgery, Oulu University Hospital, Oulu, Finland. Electronic address: faustobiancari@yahoo.it.
authors: Fausto
authors: F
authors: Biancari
authors: Division of Cardiac Surgery, University of Verona Medical School, Verona, Italy.
authors: Francesco
authors: F
authors: Onorati
authors: Cardiac Surgery Unit, A.O.U. Policlinico-Vittorio Emanuele, University of Catania, Italy.
authors: Antonino S
authors: AS
authors: Rubino
authors: Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors: Matti-Aleksi
authors: MA
authors: Mosorin
authors: Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors: Tatu
authors: T
authors: Juvonen
authors: Division of Cardiac Surgery, University of Verona Medical School, Verona, Italy.
authors: Naseer
authors: N
authors: Ahmed
authors: Division of Cardiac Surgery, University of Verona Medical School, Verona, Italy.
authors: Giuseppe
authors: G
authors: Faggian
authors: Cardiac Surgery Unit, A.O.U. Policlinico-Vittorio Emanuele, University of Catania, Italy.
authors: Carlo
authors: C
authors: Mariani
authors: Cardiac Surgery Unit, A.O.U. Policlinico-Vittorio Emanuele, University of Catania, Italy.
authors: Carmelo
authors: C
authors: Mignosa
authors: Cardiac Surgery Unit, Varese University Hospital, Varese, Italy.
authors: Marzia
authors: M
authors: Cottini
authors: Cardiac Surgery Unit, Varese University Hospital, Varese, Italy.
authors: Cesare
authors: C
authors: Beghi
authors: Cardiac Surgery Unit, Varese University Hospital, Varese, Italy.
authors: Giovanni
authors: G
authors: Mariscalco
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D047549:Coronary Artery Bypass, Off-Pump / Q000706:statistics & numerical data; D005260:Female; D005387:Finland / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000706:statistics & numerical data; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D015996:Survival Rate
keywords: CABG; coronary artery bypass; counterpulsation; emergency; intra-aortic balloon pump