Independent risk factors for in-hospital mortality after isolated coronary artery bypass graft (CABG): Clinical study in 513 patients

Purpose: The in-hospital mortality after isolated CABG in Germany averages 3–3.5% in recent years. The present clinical was designed to identify the influence of multiple preoperative stent procedures on the early post operative results in aorto-coronary bypass surgery.

Materials and methods: A clinical prospective monocenter study was carried out. During one year (2008), all consecutive patients (n=513) following isolated CABG were included and analyzed in detail. Risk factors for outcome (hospital mortality) were determined using univariate analysis (chi-square and ANOVA), bivariate correlation, and logistic regression. The observed risk and the observed adverse events were anylyzed in comparison the the calculated expected risk value (Exp(B)). Significance levels were computed on the basis of generally available statistics software (SPSS 16.0).

Results: Univariate and bivariate analysis identified 23 significant parameters for hospital mortality. Three independent risk factors were identified: Preoperative cardiopulmonary resuscitation (CPR) (Sig.0,002; Exp(B) 144,7), preoperative neurological disease (Sig.0,029; Exp(B)6,0), and IABP use (Sig.0,004; Exp(B) 62,0). The number of stent procedures, the localisation of the stents and the time between stentimplantation and surgical intervention were not identified as independent prognostic factors.

Conclusion: Based on the present study we are careful to attribute a special independent risk to preoperatiove stent procedures. However an optimization of the perioperative management may focus on the reduction of the incidence of neurological disorders, develop strategies following CPR may develop alternative strategies to IABP implantation.