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冠状动脉旁路移植术:1046例患者的30天手术发病率分析

Coronary artery bypass grafting: 30-day operative morbidity analysis in 1046 patients.

作者信息

Alwaqfi Nizar R, Khader Yousef S, Ibrahim Khaled S, Eqab Fahmi M

机构信息

Princess Muna Heart Center, Department of General Surgery, Jordan University of Science and Technology and King Abdullah University Hospital, Irbid, Jordan.

出版信息

J Clin Med Res. 2012 Aug;4(4):267-73. doi: 10.4021/jocmr1020w. Epub 2012 Jul 20.

Abstract

BACKGROUND

To determine the rate and risk factors of three operative complications (renal failure, pneumonia, and sternal wound infection) within 30 days after isolated coronary artery bypass surgery.

METHODS

Medical records of 1,046 consecutive patients between the years 2005 and 2009 were reviewed. Demographic data and peri-operative information were collected and analyzed. Univariate and multivariate analysis between different variables were performed.

RESULTS

Of all patients 3.6% developed pneumonia, 5.9% developed acute renal failure and 8.5% developed sternal wound infection. Independent predictors of acute renal failure were age > 65 years (P = 0.030), pre-operative renal impairment (P < 0.005), peripheral vascular disease (P = 0.005), emergency surgery (P = 0.043), blood transfusion (P = 0.002) mechanical ventilation > 12 hours (P < 0.005) and prolonged inotropic support (P = 0.035). Pneumonia independent predictors were female gender (P < 0.005), diabetes mellitus (P = 0.024), peripheral vascular disease (P = 0.012), emergency surgery (P = 0.007), blood transfusion (P = 0.001), mechanical ventilation > 12 hours (P = 0.005) and prolonged inotropic support (P < 0.005). Sternal wound infection independent predictors were diabetes mellitus (P = 0.017), intra- and post-operative blood transfusion (P < 0.005), and prolonged inotropic support (P = 0.006).

CONCLUSION

Age, female gender, history of diabetes mellitus, chronic obstructive pulmonary disease, peripheral vascular disease, renal impairment, emergency surgery, per-operative blood transfusion, mechanical ventilation > 12 hours and prolonged inotropic support are associated with the 30-day complication after on-pump isolated coronary artery bypass grafting surgery.

摘要

背景

确定单纯冠状动脉搭桥手术后30天内三种手术并发症(肾衰竭、肺炎和胸骨伤口感染)的发生率及危险因素。

方法

回顾了2005年至2009年间1046例连续患者的病历。收集并分析了人口统计学数据和围手术期信息。对不同变量进行单因素和多因素分析。

结果

所有患者中,3.6%发生肺炎,5.9%发生急性肾衰竭,8.5%发生胸骨伤口感染。急性肾衰竭的独立预测因素为年龄>65岁(P = 0.030)、术前肾功能损害(P < 0.005)、外周血管疾病(P = 0.005)、急诊手术(P = 0.043)、输血(P = 0.002)、机械通气>12小时(P < 0.005)和延长的正性肌力支持(P = 0.035)。肺炎的独立预测因素为女性(P < 0.

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