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Risk Factors of In-Hospital Mortality for Isolated On-Pump Coronary Artery Bypass Graft Surgery in the Northeast of Iran From 2007 to 2016 Publisher Pubmed



Nomali M1, 2 ; Heidari ME3 ; Ayati A4 ; Moghaddam K5 ; Mosallami S6 ; Khosravi A7, 8 ; Rafiei M8 ; Riahinokandeh G9 ; Yadegari M10 ; Nomali M1, 2 ; Taheriyan M12 ; Roshandel G13
Authors
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Authors Affiliations
  1. 1. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran
  3. 3. Student Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Supervisory Department, Kordkuy Amiralmomenin Hospital, Golestan University of Medical Sciences, Gorgan, Iran
  6. 6. Open Heart Intensive Care Unit, Kordkuy Amiralmomenin Hospital, Golestan University of Medical Sciences, Gorgan, Iran
  7. 7. School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Department of Surgery, School of Medicine, Sayyad Shirazi Hospital, Kordkuy Amiralmomenin Hospital, Golestan University of Medical Sciences, Gorgan, Iran
  10. 10. Bandar-E Gaz Shohada Hospital, Golestan University of Medical Sciences, Gorgan, Iran
  11. 11. Department of Biomedical Engineering, Alejalil Hospital, Golestan University of Medical Sciences, Gorgan, Iran
  12. 12. Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
  13. 13. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran

Source: Irish Journal of Medical Science Published:2023


Abstract

Background and objective: Coronary artery bypass graft (CABG) surgery is the most common cardiac surgery worldwide. The reported mortality rates for this operation vary greatly. We aimed to determine the risk factors of in-hospital mortality for isolated on-pump CABG surgery. Methods: This was a large-scale retrospective cohort study of two heart centers in Golestan province. Patients over the age of 18 from both genders who underwent isolated on-pump CABG procedures from 2007 to 2016 were included. The study outcome was in-hospital mortality, which was determined according to the clinical records of study patients. Results: A total of 3704 patients were included in the study, and 63% were men. In-hospital mortality occurred in 2.8% (n=103) of the patients. The median (IQR) age of survived and not-survived patients were 59 (53–65) and 62 (55–75) years, respectively. 44% of the mortalities occurred in patients older than 65, while 28% of the survivors were older than 65. Multivariable logistic regression indicated that emergency CABG (OR 4.52, 95% CI, 1.45, 14.02; P = 0.009) and cardiopulmonary bypass time (CPB) (OR 1.004, 95% CI 1.001, 1.008; P = 0.034) were the risk factors of in-hospital mortality. The area under the receiver operating characteristic (ROC) curve (AUC) of the model consisting of operative and preoperative variables was 0.70 (acceptable performance). Conclusion: Our study revealed an acceptable mortality proportion for CABG surgeries conducted in the region. Emergency CABG and CPB time were the main risk factors for in-hospital mortality after CABG. © 2023, The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.
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