title: Validation of a New Classification Method of Postoperative Complications in Patients Undergoing Coronary Artery Surgery.
abstract: OBJECTIVE
  The authors aimed to validate the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) classification of postoperative complications in patients undergoing coronary artery bypass grafting (CABG).
  
  
  METHODS
  Retrospective, observational study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A total of 2,764 patients with severe coronary artery disease. Complete baseline, operative, and postoperative data were available for patients who underwent isolated CABG.
  
  
  METHODS
  Isolated CABG.
  
  
  RESULTS
  The E-CABG complication classification was used to stratify the severity and prognostic impact of adverse postoperative events. Primary outcome endpoints were 30-day, 90-day, and long-term all-cause mortality. The secondary outcome endpoints was the length of intensive care unit stay. Both the E-CABG complication grades and additive score were predictive of 30-day (area under the receiver operating characteristics curve 0.866, 95% confidence interval [CI] 0.829-0.903; and 0.876; 95% CI 0.844-0.908, respectively) and 90-day (area under the receiver operating characteristics curve 0.850, 95% CI 0.812-0.887; and 0.863, 95% CI 0.829-0.897, respectively) all-cause mortality. The complication grades were independent predictors of increased mortality at actuarial (log-rank: p<0.0001) and adjusted analysis (p<0.0001; grade 1: hazard ratio [HR] 1.757, 95% CI 1.111-2.778; grade 2: HR 2.704, 95% CI 1.664-4.394; grade 3: HR 5.081, 95% CI 3.148-8.201). When patients who died within 30 days were excluded from the analysis, this grading method still was associated with late mortality (p<0.0001). The grading method (p<0.0001) and the additive score (rho, 0.514; p<0.0001) were predictive of the length of intensive care unit stay.
  
  
  CONCLUSIONS
  The E-CABG postoperative complication classification seems to be a promising tool for stratifying the severity and prognostic impact of postoperative complications in patients undergoing cardiac surgery.
authors.affiliation: Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors.forename: Eeva-Maija
authors.initials: EM
authors.lastname: Kinnunen
authors.affiliation: Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors.forename: Matti-Aleksi
authors.initials: MA
authors.lastname: Mosorin
authors.affiliation: Division of Cardiothoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Andrea
authors.initials: A
authors.lastname: Perrotti
authors.affiliation: Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France.
authors.forename: Vito G
authors.initials: VG
authors.lastname: Ruggieri
authors.affiliation: Department of Molecular Medicine and Surgery, Department of Cardiothoracic Surgery and Anesthesiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Svenarud
authors.affiliation: Division of Cardiovascular Surgery, Verona University Hospital, Verona, Italy.
authors.forename: Magnus
authors.initials: M
authors.lastname: Dalén
authors.affiliation: Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.
authors.forename: Francesco
authors.initials: F
authors.lastname: Onorati
authors.affiliation: Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Faggian
authors.affiliation: Department of Cardiac Surgery, St. Anna Hospital, Catanzaro, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santarpino
authors.affiliation: Department of Cardiac Surgery, St. Anna Hospital, Catanzaro, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Maselli
authors.affiliation: Department of Cardiac Surgery, St. Anna Hospital, Catanzaro, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Dominici
authors.affiliation: Department of Cardiac Surgery, St. Anna Hospital, Catanzaro, Italy.
authors.forename: Saverio
authors.initials: S
authors.lastname: Nardella
authors.affiliation: Unit of Cardiac Surgery, Department of Cardiosciences, Hospital S. Camillo-Forlanini, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Musumeci
authors.affiliation: Unit of Cardiac Surgery, Department of Cardiosciences, Hospital S. Camillo-Forlanini, Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Gherli
authors.affiliation: Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester, United Kingdom.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mariscalco
authors.affiliation: Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester, United Kingdom.
authors.forename: Nicola
authors.initials: N
authors.lastname: Masala
authors.affiliation: Centro Cuore Morgagni, Pedara, Italy.
authors.forename: Antonino S
authors.initials: AS
authors.lastname: Rubino
authors.affiliation: Centro Cuore Morgagni, Pedara, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Mignosa
authors.affiliation: Division of Cardiac Surgery, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: De Feo
authors.affiliation: Division of Cardiac Surgery, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Della Corte
authors.affiliation: Division of Cardiac Surgery, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Bancone
authors.affiliation: Division of Cardiothoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Sidney
authors.initials: S
authors.lastname: Chocron
authors.affiliation: Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy; Division of Cardiothoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gatti
authors.affiliation: Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors.forename: Tatu
authors.initials: T
authors.lastname: Juvonen
authors.affiliation: Department of Surgery, Oulu University Hospital, Oulu, Finland. Electronic address: faustobiancari@yahoo.it.
authors.forename: Fausto
authors.initials: F
authors.lastname: Biancari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000601:surgery*; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification* / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
keywords: cardiac surgery; classification; complication; coronary artery bypass grafting