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- Title
Emergency Coronary Artery Bypass Grafting: Indications and Outcomes from 2003 through 2013.
- Authors
Schumer, Erin M.; Chaney, John H.; Trivedi, Jaimin R.; Linsky, Paul L.; Williams, Matthew L.; Slaughter, Mark S.
- 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.
- Subjects
UNITED States; CORONARY artery bypass; PATIENTS; CARDIOVASCULAR diseases; CARDIOVASCULAR disease related mortality; ISCHEMIA treatment; PUBLIC health
- Publication
Texas Heart Institute Journal, 2016, Vol 43, Issue 3, p214
- ISSN
1526-6702
- Publication type
Article
- DOI
10.14503/THIJ-14-4978