Emergency Coronary Artery Bypass Grafting: Indications and Outcomes from 2003 through 2013. Tex Heart Inst J 2016 Jun;43(3):214-9
Date
06/16/2016Pubmed ID
27303236Pubmed Central ID
PMC4894699DOI
10.14503/THIJ-14-4978Scopus ID
2-s2.0-84973349050 (requires institutional sign-in at Scopus site) 31 CitationsAbstract
Emergency coronary artery bypass grafting (CABG) is associated with increased in-hospital mortality rates and adverse events. This study retrospectively evaluated indications and outcomes in patients who underwent emergency CABG. The Society of Thoracic Surgeons database for a single center (Jewish Hospital) was queried to identify patients undergoing isolated CABG. Univariate analysis was performed. From January 2003 through December 2013, 5,940 patients underwent CABG; 212 presented with emergency status. A high proportion of female patients (28.2%) underwent emergency surgery. Emergency CABG patients experienced high rates of intra-aortic balloon pump support, bleeding, dialysis, in-hospital death, and prolonged length of stay. The proportion of emergency coronary artery bypass grafting declined during years 2008-2013 compared with 2003-2007 (2.2% vs. 4.5%, P < 0.001), but the incidence of angiographic accident (5.3% vs. 29.2%) increased as an indication. Ongoing ischemia remains the most frequent indication for emergency CABG, yet the incidence of angiographic accident has greatly increased. In-hospital mortality rates and adverse events remain high. If we look specifically at emergency CABG cases arising from angiographic accident, we find that 14 (15%) of all 93 emergency CABG deaths occurred in that subset of patients. Efforts to improve outcomes should therefore be focused on this high-risk group.
Author List
Schumer EM, Chaney JH, Trivedi JR, Linsky PL, Williams ML, Slaughter MSAuthor
Paul L. Linsky MD Assistant Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acute Coronary SyndromeCoronary Angiography
Coronary Artery Bypass
Emergencies
Female
Follow-Up Studies
Forecasting
Hospital Mortality
Humans
Kentucky
Male
Middle Aged
Retrospective Studies
Risk Assessment
Survival Rate