دورية أكاديمية
Mortality and morbidity of patients on the waiting list for coronary artery bypass graft surgery.
| العنوان: | Mortality and morbidity of patients on the waiting list for coronary artery bypass graft surgery. |
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| المؤلفون: | da Fonseca VBP; Division of Clinical Care, Instituto Nacional de Cardiologia (INC), Rio de Janeiro, Brazil., De Lorenzo A; Division of Education and Research, Instituto Nacional de Cardiologia (INC), Rio de Janeiro, Brazil., Tura BR; Division of Education and Research, Instituto Nacional de Cardiologia (INC), Rio de Janeiro, Brazil., Pittella FJM; Department of Coronary Artery Disease, Instituto Nacional de Cardiologia (INC), Rio de Janeiro, Brazil., da Rocha ASC; Division of Education and Research, Instituto Nacional de Cardiologia (INC), Rio de Janeiro, Brazil. |
| المصدر: | Interactive cardiovascular and thoracic surgery [Interact Cardiovasc Thorac Surg] 2018 Jan 01; Vol. 26 (1), pp. 34-40. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 101158399 Publication Model: Print Cited Medium: Internet ISSN: 1569-9285 (Electronic) Linking ISSN: 15699285 NLM ISO Abbreviation: Interact Cardiovasc Thorac Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2012-2022 : Oxford, England : Oxford University Press Original Publication: Amsterdam, The Netherlands ; New York : Elsevier Science, c2002- |
| مواضيع طبية MeSH: | Coronary Artery Bypass* , Waiting Lists*, Heart Diseases/*complications , Heart Diseases/*mortality, Aged ; Brazil ; Female ; Heart Diseases/surgery ; Humans ; Male ; Middle Aged ; Morbidity ; Proportional Hazards Models ; Retrospective Studies |
| مستخلص: | Objectives: The public health care system in Brazil has extensive waiting lists of patients requiring complex operations such as coronary artery bypass grafting (CABG). The purpose of this study was to identify the mortality and morbidity rates of the patients awaiting CABG and identify predictors of adverse events and their association with perioperative outcomes. Methods: We conducted a retrospective analysis of outpatient medical records of patients referred for this elective procedure in Rio de Janeiro, Brazil. Excluded from the study were records of patients with any of the following: an indication for urgent surgery, unstable angina or concomitant surgical valvular disease or subsequent transfer to clinical or percutaneous therapy. Results: A total of 274 patients were identified and met the inclusion criteria, with a median waiting time for an operation of 142.7 days. While waiting for CABG surgery, 31 (11.3%) patients died of any cause and 42 (15.3%) patients had a serious cardiac event (death, myocardial infarction or unstable angina). Of the 22 (8%) incidents of acute myocardial infarction, 8 (2.9%) were non-fatal and 14 (5.1%) were fatal. There was a greater risk of death awaiting CABG surgery in patients with a left ventricular ejection fraction below 45% (hazard ratio = 2.33, 95% confidence interval 1.02-5.32; P = 0.039). The operative mortality rate was 5.8%. Although there was no evidence of worse perioperative outcomes in patients with prolonged waiting times for an operation, there was an association between waiting more than 16 weeks for an operation and death while on the list. Conclusions: Extensive waiting periods for CABG contribute to higher mortality and morbidity rates, especially in patients with left ventricular dysfunction. (© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Coronary artery bypass surgery; Coronary disease; Myocardial revascularization; Waiting lists |
| تواريخ الأحداث: | Date Created: 20171020 Date Completed: 20181120 Latest Revision: 20181120 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1093/icvts/ivx276 |
| PMID: | 29049704 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1569-9285 |
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| DOI: | 10.1093/icvts/ivx276 |