择期冠状动脉旁路移植术后心脏并发症的预测因素和结果。

M Charlson, K H Krieger, J C Peterson, J Hayes, O W Isom
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引用次数: 14

摘要

我们的目的是确定选择性冠状动脉旁路移植术(CABG)患者心脏并发症的预测因素,并确定这些并发症与随后的生活质量和症状的关系。共有248名患者入组,237名患者完成了6个月的随访。主要和次要心脏并发症合并发生率为9.7% (n = 24)。本研究中的患者术前评估,术中监测,术后和6个月后立即随访。主要心脏并发症占3.6% (n = 9),轻微并发症占6% (n = 15)。采用多变量logistic回归分析,主要心脏并发症的预测因素是术前使用利尿剂(p = 0.01)和交叉夹持时间增加(p = 0.006)。术后6个月,有心脏并发症的患者中有19%出现症状恶化,而无心脏并发症的患者中只有8%出现症状恶化(p = .03)。我们得出结论,术前使用利尿剂和交叉钳夹时间较长的患者心脏并发症的风险较高。大多数有急性心脏并发症的患者在术后6个月功能和症状得到改善。
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Predictors and outcomes of cardiac complications following elective coronary bypass grafting.

Our objective was to determine the predictors of cardiac complications among a cohort of elective coronary artery bypass graft (CABG) surgery patients and to determine the relationship of such complications to subsequent quality of life and symptoms. A total of 248 patients were enrolled and 237 completed 6 month follow-up. The combined rate of both major and minor cardiac complications was 9.7% (n = 24). Patients in this study were evaluated preoperatively, monitored intraoperatively, followed immediately postoperatively and at 6 months. Major cardiac complications accounted for 3.6% (n = 9) and minor complications for 6% (n = 15). Using multivariable logistic regression analysis, the predictors of major cardiac complications were receiving diuretics preoperatively (p = .01) and increased time during cross-clamping (p = .006). At 6 months after surgery, 19% of the patients with postoperative cardiac complications experienced worsening of symptoms, in contrast to only 8% of those without cardiac complications (p = .03). We concluded that patients who were on preoperative diuretics and those who had longer cross-clamp times were at higher risk of cardiac complications. The majority of patients who had acute cardiac complications had improved function and symptoms at 6 months postoperatively.

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