Trends of Coronary Artery Bypass Grafting Performance in a Cohort of Hospitals in China Between 2013 and 2018

Abstract

Background: China has witnessed a rapid increase in the volume of coronary artery bypass grafting (CABG) but substantial gaps in the performance for CABG across the nation. The present study aimed to investigate the change in CABG performance after years of quality improvement measures in a national registry in China. Methods: The study included 66 971 patients who underwent isolated CABG in a cohort of 74 tertiary hospitals in China between January 2013 and December 2018. Data were collected from the Chinese Cardiac Surgery Registry. Outcomes were in-hospital mortality and postoperative length of stay. Five process measures for surgical technique and secondary prevention were also analyzed. We described the changes in the overall performance and interhospital heterogeneity across the years. Results: The in-hospital mortality declined from 0.9% in 2013 to 0.6 in 2018, with a risk-adjusted odds ratio of 0.66 (95% CI, 0.46–0.93; P <0.001). The standard mean difference for risk-standardized mortality rate between hospitals in the lowest and highest quartile narrowed from 1.63 in 2013 to 1.35 in 2018. The median (interquartile range) hospital-level rate of using arterial graft increased from 93.9% (86.0%–97.8%) to 94.6% (83.3%–99.2%), but the difference was not statistically significant. Meanwhile, the rate of free from blood transfusion increased from 17.0% (2.6%–32.0%) to 34.1% (8.8%–52.9%). The hospital-level rate of prescribing β-blockers at discharge significantly increased from 82.8% (66.7%–90.3%) to 91.1% (82.1%–97.1%), statin from 75.8% (55.7%–88.9%) to 88.9% (75.0%–96.0%), and aspirin from 90.3% (83.9%–95.2%) to 95.3% (88.9%–98.1%). Conclusions: In the Chinese Cardiac Surgery Registry, there were notable improvements in the treatment process related to CABG and decline of in-hospital mortality with reduced interhospital heterogeneity.

Impact of High Lipoprotein(a) on Long‐Term Survival Following Coronary Artery Bypass Grafting

“… 36 , 38 Although the usage of arterial grafts is increasing worldwide, there are still substantial numbers of patients who only received SVG due to the limitation of graft conditions or surgeon technique, especially in developing countries. 39 Our study highlights the importance of the usage of arterial grafts and standardized training, especially in an era when the prevalence of elevated lipoprotein(a) is high and gradually increasing.…”

Pattern Changes in the Heart Rate Variability of Patients Undergoing Coronary Artery Bypass Grafting Surgery

“…The mean BMI of the patients was 22.99 ± 2.85 (ranging between 15.99 and 30.8). Being under/overweight or obese increases the frequency of pneumonia and it can be difficult to wean such patients off mechanical ventilation in the early stages of surgery [ 24 ]. Hypertension-related diseases were prevalent in 103 of the patients.…”

The effectiveness of a web-based information-knowledge-attitude-practice continuous intervention on the psychological status, medical compliance, and quality of life of patients after coronary artery bypass grafting surgery: a parallel randomized clinical trial

“…Coronary artery disease (CAD), one of the most commonly diagnosed cardiovascular diseases (CVD), has been rapidly increasing among the Chinese population in recent years [ 1 , 2 ]. A recent report has confirmed that nearly 11 million patients with CVD in China benefit from coronary artery bypass grafting (CABG) operations throughout the country [ 3 ], which demonstrated effective efforts to improve symptoms of coronary artery lesions, restore blood supply, prevent myocardial infarction, and increase patients’ chances of survival [ 4 ]. Nevertheless, due to the inevitable pathological and physiological dysfunctions caused by the CABG postoperative procedure, it takes a long time for CAD patients to recover, especially after they are discharged from the hospital [ 5 ].…”