Ribera Aida, Ferreira-González Ignacio, Cascant Purificación, Marsal Josep Ramón, Romero Bernat, Pedrol Daniel, Martínez-Useros Carmen, Pons Joan M V, Fernández Teresa, Permanyer-Miralda Gaietà
CIBER de Epidemiología y Salud Pública, Unidad de Epidemiología, Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, España.
Rev Esp Cardiol. 2009 Jun;62(6):642-51. doi: 10.1016/s1885-5857(09)72228-5.
Little is known about the long-term outcomes of coronary surgery and their determinants in Spain. The objectives of this study were to evaluate clinical outcomes, quality of life and survival in a cohort of patients 5 years after undergoing a first aortocoronary bypass operation without any other associated procedure.
Patients who survived the operation and whose pre- and postoperative data had been collected prospectively were followed up by telephone interview after 5 years.
Information was available after 5 years on 1,300 (85.2%) of the 1,525 patients who survived until hospital discharge. Of these, 13.6% had died, while 24% had either died, undergone revascularization or were readmitted because of a cardiac complaint. The cumulative survival rate (excluding the period of hospitalization) was 0.87 (95% confidence interval, 0.85-0.89). Mortality varied significantly with the level of preoperative risk (i.e. the EuroSCORE), to the extent that mortality in the low-risk group was equivalent to that in the general reference population.
Three-quarters of patients who survived until hospital discharge after coronary surgery did not experience a major cardiac event within 5 years and their level of functioning and quality of life were good. The survival rate after the immediate postoperative period varied according to the patient's preoperative risk profile and, in low-risk patients, was equivalent to that in the general reference population.
在西班牙，关于冠状动脉手术的长期预后及其决定因素知之甚少。本研究的目的是评估首次接受单纯主动脉冠状动脉搭桥手术且无其他相关手术的患者队列在术后5年的临床结局、生活质量和生存率。
对手术存活且术前和术后数据已前瞻性收集的患者，在5年后通过电话访谈进行随访。
在1525例存活至出院的患者中，5年后有1300例（85.2%）获得了相关信息。其中，13.6%的患者死亡，24%的患者因心脏问题死亡、接受了血运重建或再次入院。累积生存率（不包括住院期间）为0.87（95%置信区间，0.85 - 0.89）。死亡率随术前风险水平（即欧洲心脏手术风险评估系统评分）显著变化，低风险组的死亡率与一般参考人群相当。
冠状动脉手术后存活至出院的患者中，四分之三在5年内未发生重大心脏事件，其功能水平和生活质量良好。术后即刻的生存率根据患者术前风险状况而异，低风险患者的生存率与一般参考人群相当。
