TY - JOUR
T1 - Intraoperative physiologic variables and outcome in cardiac surgery
T2 - Part I. In-hospital mortality
AU - Hill, Steven E.
AU - Van Wermeskerken, Gijs K.
AU - Lardenoye, Jan Willem H.
AU - Phillips-Bute, Barbara
AU - Smith, Peter K.
AU - Reves, Joseph G.
AU - Newman, Mark F.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2000/4
Y1 - 2000/4
N2 - Background. Risk stratification schemes have been developed to predict outcome of coronary artery bypass grafting (CABG) procedures, which are predominately based upon unalterable preoperative patient characteristics. The purpose of this study was to determine if minimum intraoperative hematocrit, maximum glucose concentration, mean arterial pressure on cardiopulmonary bypass, or duration of bypass influence risk-adjusted in- hospital mortality after CABG. Methods. Outcome data from 2,862 CABG patients were merged with intraoperative physiologic data. A preoperative mortality risk index was calculated for each patient. Variables found significant (p < 0.05) by univariate logistic regression were tested in a multiple variable model to determine risk-adjusted association with mortality. Results. Overall mortality rate was 1.85%. The preoperative risk index was significantly associated with mortality (p = 0.0001). No significant association was present between mortality and intraoperative variables. Preexisting hypertension was an independent predictor of mortality after controlling for risk index and bypass duration. Conclusions. Preexisting hypertension proved to be an independent predictor of mortality in our patient population. This study found no evidence to support the hypothesis that mean arterial pressure less than 50 mm Hg, lower hematocrit, or elevated glucose while on bypass increases in-hospital mortality. (C) 2000 by The Society of Thoracic Surgeons.
AB - Background. Risk stratification schemes have been developed to predict outcome of coronary artery bypass grafting (CABG) procedures, which are predominately based upon unalterable preoperative patient characteristics. The purpose of this study was to determine if minimum intraoperative hematocrit, maximum glucose concentration, mean arterial pressure on cardiopulmonary bypass, or duration of bypass influence risk-adjusted in- hospital mortality after CABG. Methods. Outcome data from 2,862 CABG patients were merged with intraoperative physiologic data. A preoperative mortality risk index was calculated for each patient. Variables found significant (p < 0.05) by univariate logistic regression were tested in a multiple variable model to determine risk-adjusted association with mortality. Results. Overall mortality rate was 1.85%. The preoperative risk index was significantly associated with mortality (p = 0.0001). No significant association was present between mortality and intraoperative variables. Preexisting hypertension was an independent predictor of mortality after controlling for risk index and bypass duration. Conclusions. Preexisting hypertension proved to be an independent predictor of mortality in our patient population. This study found no evidence to support the hypothesis that mean arterial pressure less than 50 mm Hg, lower hematocrit, or elevated glucose while on bypass increases in-hospital mortality. (C) 2000 by The Society of Thoracic Surgeons.
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U2 - 10.1016/S0003-4975(99)01442-3
DO - 10.1016/S0003-4975(99)01442-3
M3 - Article
C2 - 10800796
AN - SCOPUS:0034060775
SN - 0003-4975
VL - 69
SP - 1070
EP - 1075
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 4
ER -