Supervisors info:
Κωνσταντίνος Τούτουζας, Καθηγητής, Ιατρική σχολή, ΕΚΠΑ
Ελένη Κυρίτση, Ομότιμη Καθηγήτρια, Νοσηλευτική, ΠΑΔΑ
Δημήτριος Τούσουλης, Ομότιμος Καθηγητής, Ιατρική σχολή, ΕΚΠΑ
Summary:
Introduction: Coronary artery bypass graft surgery is often considered a high-risk procedure, associated with a morbidity and mortality rate within 30 days of up to 14.0% and 2.0%, respectively. Overall, 7% of patients after CABG surgery will experience more than one ED visit or readmission within 30 days of surgery.
Purpose: The purpose of this study was to assess the outcome of patients undergoing emergency coronary artery bypass grafting compared with that of patients after planned coronary artery bypass grafting.
Material and Methods: 125 patients who underwent coronary artery bypass grafting and were hospitalized in the cardiac surgery unit and clinic of the General Hospital "IPOKRATEION" from 1/1/2022 to 31/12/2022 were the sample of the study. Data were collected by completing a data collection form specifically designed for the study. Data were collected from patient records and recorded demographic and clinical characteristics related to the patients' medical history, and characteristics related to the procedure. The SPSS-25 statistical package was used for statistical analysis and the t-test, anova, x2-test and Pearson correlation statistical tests were applied. Statistical significance was set at ≤5%.
Results: Of the 125 patients who underwent coronary artery bypass grafting, 44% of the admissions were emergency and 79.2% were male. Postoperative confusion was present in 26.4%, pulmonary embolism in 2.4%, conduction disturbances in 22.4%, bleeding in 7.2%, readmission to surgery in 6.4% cardiogenic shock in 2.4%, infection in 5.6% atrial fibrillation in 7.2%, and pacemaker implantation in 2.4%. Patients with an ejection fraction <50%, (p=0.002), younger age, (p=0.036), and more frequently underwent an off pump procedure, (p=0.006) underwent emergency coronary artery bypass grafting. In relation to outcome, death was more frequently observed in emergency coronary artery bypass grafting, (p=0.003), in patients with low ejection fraction, (p=0.021), with abnormal urea values, pre- and post-operatively, (p<0.001), (p=0.002), creatinine after surgery, (p=0.034), pre-surgery, (p=0.021), in older subjects 74.4 vs 66.1, (p=0.023), with longer duration of mechanical support, (p=0.002), and duration of sedation, (p=0.002).
Conclusion: In the present study a large proportion underwent emergency coronary artery bypass grafting which more often involved younger people and was responsible for the higher incidence of deaths. Apart from the type of admission, other clinical factors were responsible for the poor outcome of the patients
Keywords:
Coronary artery bypass grafting, Cardiogenic shock, Atrial fibrilation, Pacemaker, Surgery
