Department of Orthopedics and Traumatology, Jorvi Hospital, Espoo, Finland.
Eur J Cardiothorac Surg. 2011 Jul;40(1):249-54. doi: 10.1016/j.ejcts.2010.10.042. Epub 2010 Dec 17.
Follow-up studies of patients surviving emergency resternotomy, open cardiac massage, and additional emergency cardiac surgery following coronary artery bypass grafting (CABG) remain sparse and studies focusing on health-related quality of life are lacking. Our aim was to elucidate the long-term course of patients experiencing this hazardous complication.
Between 1988 and 1999, 76 patients suffered sudden hemodynamic collapse following isolated CABG. All patients underwent emergency resternotomy and open cardiac massage. An emergency cardiac reoperation was performed in the 62 (82%) primary survivors. Additional 76 patients were pair-matched to the study patients on the basis of their preoperative characteristics and served as controls. Of the study patients, 41 (54%), and of the controls, 76, (100%) were discharged. In December 2009, all patients were traced with respect to mortality data and the health-related quality of life of living patients was studied using the RAND-36 Item Health Survey questionnaire.
Altogether 19 (73%) of the 26 study patients, and 38 (84%) of the 45 controls were available. After exclusion of the early deaths, the life expectancy was similar between the groups: neither overall (p = 0.60) nor cardiac (p = 0.64) survival differed significantly after a mean follow-up time of 15.1 ± 3.5 years. In addition, cardiac re-interventions were equally frequently required in both the groups. The RAND-36 scores were congruent (p = ns) between the groups and the age- and sex-matched national reference population in the health-related quality-of-life dimensions describing physical, mental, and social domains.
Patients who have survived severe hemodynamic collapse, open cardiac massage, and emergency cardiac reoperation following CABG achieve similar long-term prognosis in terms of survival and cardiac interventions as the pair-matched control patients. In addition, 15 years postoperatively, they have a good health-related quality of life, similar to that of an age- and sex-matched national reference population.
接受急诊开胸心脏按压和冠状动脉旁路移植术（CABG）后再次紧急心脏手术的患者的随访研究仍然很少，并且缺乏关注健康相关生活质量的研究。我们的目的是阐明经历这种危险并发症的患者的长期病程。
1988 年至 1999 年间，76 例患者在单独进行 CABG 后出现急性血流动力学崩溃。所有患者均接受急诊开胸和心脏按压。62 例（82%）原发性幸存者进行了紧急心脏再手术。另外 76 名患者基于术前特征与研究患者进行配对匹配，并作为对照组。研究患者中，41 例（54%）和对照组中，76 例（100%）出院。2009 年 12 月，对所有患者进行了死亡率数据的追踪，并使用 RAND-36 项健康调查问卷研究了存活患者的健康相关生活质量。
26 例研究患者中有 19 例（73%）和 45 例对照组中有 38 例（84%）可用。排除早期死亡后，两组之间的预期寿命相似：总体生存率（p=0.60）和心脏生存率（p=0.64）均无显著差异，平均随访时间为 15.1±3.5 年。此外，两组都需要进行心脏再干预。两组之间的 RAND-36 评分相似（p=ns），并且在描述身体、心理和社会领域的健康相关生活质量维度上与年龄和性别匹配的全国参考人群相似。
在 CABG 后经历严重血流动力学崩溃、开胸心脏按压和急诊心脏再手术的患者，在生存和心脏干预方面具有与配对匹配对照组患者相似的长期预后。此外，术后 15 年，他们的健康相关生活质量良好，与年龄和性别匹配的全国参考人群相似。
