Impact of coronary artery bypass grafting in elderly patients

Aikawa, Priscila; Cintra, Angélica Rossi Sartori; Leite, Cléber Aparecido; Marques, Ricardo Henrique; Silva, Claudio Tafarel Mackmillan da; Afonso, Max dos Santos; Paulitsch, Felipe da Silva; Oss, Evandro Augusto

doi:10.5935/1678-9741.20130005

Cited by 8 publications

(7 citation statements)

References 17 publications

(23 reference statements)

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“…Naughton et al [ 23 ] studied 3,683 patients undergoing CABG and found that age ≥ 75 years was an independent risk factor for mortality within 30 days. However, Aikawa et al [ 4 ] investigating the impact of CABG on 253 elderly patients, found that age ≥ 65 years was not associated with death variable.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of CAD may be clinical/medical or surgical. Despite advances in medical therapy and PCI, coronary artery bypass grafting (CABG) is a safe procedure performed worldwide with low rates of mortality and morbidity in the general population [ 4 ] and it is still excellent option for treatment of obstructive CAD [ 5 ] , even in diabetic patients [ 6 ] , the elderly [ 7 ] and in patients with low left ventricular ejection fraction [ 8 ] . In addition, the CABG can control the persistent ischemia and progression to acute myocardial infarction, in addition to provide symptomatic relief and prevent ischemic complications [ 9 ] .…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for mortality of patients undergoing coronary artery bypass graft surgery

Santos¹,

Oliveira²,

Brandi³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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IntroductionCoronary artery bypass grafting is a safe procedure performed worldwide with low rates of mortality and morbidity in general population.ObjectiveTo investigate risk factors for mortality of patients undergoing coronary artery bypass grafting coronary artery bypass grafting surgery.MethodsA total of 1,628 consecutive patients undergoing on-pump coronary artery bypass grafting were retrospectively studied from December 1999 to February 2012. Data analysis involved paired Student t test, Mann-Whitney test and Fisher’s exact test for the categorical data. Logistic regression, Odds Ratio and 95%CI were used for definition of risk factors for mortality.ResultsOf a total of 1,628 patients undergoing on-pump coronary artery bypass grafting, 141 (8.7%) died. The following risk factors for mortality were identified after logistic regression: dialysis (OR=7.61; 95%CI 3.58-16.20), neurologic dysfunction type I (OR=4.42; 95%CI 2.48-7.81), use of IABP (OR=3.38; 95%CI 1.98-5.79), cardiopulmonary bypass time (OR=3.09; 95%CI 2.04-4.68), serum creatinine on admission and peak values > 0.4mg/dL (OR=2.67; 95%CI 1.79-4.00), age > 65 years (OR=2.31; 95%CI 1.55-3.44), and time between hospital admission and and surgical procedure (OR=1.53; 95%CI 1.03-2.27).ConclusionDialysis, type I neurologic dysfunction, use of IABP, cardiopulmonary bypass time (> 115 minutes), serum creatinine on admission and peak values>0.4mg/dL, age > 65 years and time between hospital admission and surgical procedure were considered as risk factors for mortality in patients undergoing on-pump coronary artery bypass grafting surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors for mortality of patients undergoing coronary artery bypass graft surgery

Santos¹,

Oliveira²,

Brandi³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

View full text Add to dashboard Cite

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“…Since mortality associated with the heart failure is significantly high, it is important to perform revascularization in patients who might benefit from this procedure. According to a meta-analysis study, revascularization procedures have provided improvements in 79.6% of patients with viable tissue [ 3 ] . Viability assessment have gained importance ever since risk factors associated with CABG operations, especially in elderly patients, have become known [ 4 , 5 ] .…”

Section: Discussionmentioning

confidence: 99%

“…F-18 FDG PET has been considered as the gold standard imaging method for detection of myocardial viability [ 18 ] . Additionally, according to previous studies, F-18 FDG PET has been able to provide prognostic information [ 3 , 19 ] .…”

Section: Discussionmentioning

confidence: 99%

Twenty four hour imaging delay improves viability detection by Tl-201 myocardial perfusion scintigraphy

Koç¹,

Balcı²,

Dağlı³

2013

Revista Brasileira De Cirurgia Cardiovascular

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Objective Since twenty-four-hour imaging by Tl-201 myocardial perfusion scintigraphy has been introduced as an effective additional procedure, the aim of this study was to compare this method's result with only rest redistribution procedure in the diagnosis of myocardial viability. Methods Thirty patients (Seven female, 23 male; mean: 59.8 ± 10.7, 55.8-63.8 years old) with diagnosis of coronary artery disease were involved in this study. All patients had anamnesis of previous myocardial infarction and/or total occlusion of any main artery in the coronary angiography. Myocardial perfusion scintigraphy with Tl-201 with rest four hour (early) redistribution and 24 hour delayed redistribution protocol were performed to all of the patients. The images were evaluated according to 17 segment basis by an experienced nuclear medicine physician and improvement of a segment by visual interpretation was considered as viable myocardial tissue. Results Viability was found at 52 segments in the early redistribution images and additional 18 segments in the 24 hour delayed redistribution images on segment basis in the evaluation of 510 segments of 30 patients. On per patient basis, among the 26 patients who had viable tissue, 14 (54%) had additional improvement in 24 hour delayed images. Three (12%) patients had viable tissue in only 24 hour delayed images. Conclusion Delayed imaging in Tl-201 MPS is a necessary application for the evaluation of viable tissue according to considerable number of patients with additional improvement in 24 hour images in our study, which is restricted to the patients with myocardial infarct.

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“…Além disso, a baixa perfusão renal, a hipotensão arterial e a queda do débito cardíaco são fatores que aceleram a disfunção renal. Apesar de todo o aperfeiço-amento técnico, processos infecciosos têm alta incidência, sendo uma das maiores causas de morbidade e mortalidade em pacientes cirúrgicos (3,(15)(16)(17)(18) . …”

Section: Methodsunclassified

Complicações Pós-Operatórias Em Pacientes Submetidos À Cirurgia Cardíaca Em Hospital De Ensino

Beccária¹,

Cesarino²,

Werneck³

et al. 2015

ACS

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ResumoIntrodução: A taxa de mortalidade hospitalar é indicador de resultados para avaliação da qualidade da assistência em unidade coronária. Objetivos: Caracterizar os pacientes submetidos à cirurgia cardíaca, identificar os tipos de cirurgia e as principais complicações nos primeiros 30 dias pós-cirurgia. Material e Métodos: Estudo retrospectivo, longitudinal, quantitativo envolvendo pacientes submetidos a cirurgia cardíaca em um hospital de ensino, de janeiro de 2003 a abril de 2012. Resultados: Foram avaliados 2.648 pacientes, 61% do sexo masculino e 39% do feminino, com idade entre 49 a 66 anos, com média de Índice de Massa Corpórea de 26. As doenças de base mais comuns foram Diabetes Mellitus e Doença Renal Crônica. Realizaram revascularização do miocárdio 1.641 pacientes (62%) e cirurgia valvar 1.007 (38%). As principais complicações pós-operatórias foram lesão renal aguda até 7º dia pós-operatório (32%), disfunção de ventrículo esquerdo moderada/grave (20%), reintubação por complicações pulmonares (11%), fibrilação atrial (8,6%) e lesão neurológica (4,3%). O tempo médio de permanência na Unidade Coronária foi de 6,8 dias e a maioria necessitou de circulação extracorpórea. Dos 22% de pacientes com história pregressa de diabetes, 25% morreram. Conclusões: A maioria submeteu-se à revascularização do miocárdio; 65% desenvolveram lesão renal aguda e 44% foram reintubados por complicações pulmonares e associação significativa com óbito. Dos 190 pacientes que morreram nos primeiros 30 dias, as complicações de maior prevalência foram afecções cardíacas, infecção hospitalar, distúrbio de coagulação, complicações neurológicas e pulmonares. Descritores:Complicações; Óbito; Pós-operatório; Cirurgia Cardíaca. Abstract Introduction: Hospital mortality rate is an indicator of outcomes to evaluate the quality of health care in a coronary care unit. Objectives: The aims of the present study are to characterize patients undergoing cardiac surgery, as well as to identify the types of surgery and its main complications in the first 30 postoperative days. Material and Methods: We carried out a retrospective longitudinal study using a quantitative approach involving patients who underwent cardiac surgery at a teaching hospital from January 2003 to April 2012. Results: We evaluated 2,648 patients, 61% males, and 39% females, with a mean age ranging from 49 to 66 years. Patients mean Body Mean Index was 26. The most common underlying diseases were diabetes mellitus and chronic renal insufficiency. We performed Coronary Artery Bypass Grafting in 1,641 patients (62%) and heart valve surgery in 1,007 (38%). The main postoperative complications were acute kidney injury on the 7 th postoperative day 7 (32%), moderate to severe left ventricular dysfunction (20%), reintubation due to pulmonary complications (11%), atrial fibrillation (8.6%), and neurological lesions (4.3%). The mean length of stay in Coronary Care Unit was 6.8 days. The majority of the patients required cardiopulmonary bypass. Of the 22% of patients with a prior histo...

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Impact of coronary artery bypass grafting in elderly patients

Cited by 8 publications

References 17 publications

Risk factors for mortality of patients undergoing coronary artery bypass graft surgery

Risk factors for mortality of patients undergoing coronary artery bypass graft surgery

Twenty four hour imaging delay improves viability detection by Tl-201 myocardial perfusion scintigraphy

Complicações Pós-Operatórias Em Pacientes Submetidos À Cirurgia Cardíaca Em Hospital De Ensino

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