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Emergency Coronary Artery Bypass Grafting: Indications and Outcomes from 2003 through 2013. Tex Heart Inst J 2016 Jun;43(3):214-9

Date

06/16/2016

Pubmed ID

27303236

Pubmed Central ID

PMC4894699

DOI

10.14503/THIJ-14-4978

Scopus ID

2-s2.0-84973349050 (requires institutional sign-in at Scopus site)   31 Citations

Abstract

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 MS

Author

Paul L. Linsky MD Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Acute Coronary Syndrome
Coronary Angiography
Coronary Artery Bypass
Emergencies
Female
Follow-Up Studies
Forecasting
Hospital Mortality
Humans
Kentucky
Male
Middle Aged
Retrospective Studies
Risk Assessment
Survival Rate