Ergüneş Kazim, Yurekli Ismail, Celik Ersin, Yetkin Ufuk, Yilik Levent, Gurbuz Ali
Department of Cardiovascular Surgery, İzmir Katip Celeby University Atatürk Training and Research Hospital, Turkey.
Korean J Thorac Cardiovasc Surg. 2013 Dec;46(6):444-8. doi: 10.5090/kjtcs.2013.46.6.444. Epub 2013 Dec 6.
We aimed to investigate the preoperative, operative, and postoperative factors affecting intra-aortic balloon pump (IABP) insertion in patients undergoing isolated on-pump coronary artery bypass grafting (CABG). We also investigated factors affecting morbidity, mortality, and survival in patients with IABP support.
Between January 2002 and December 2009, 1,657 patients underwent isolated CABG in İzmir Katip Celebi University Atatürk Training and Research Hospital. The number of patients requiring support with IABP was 134 (8.1%).
In a multivariate logistic regression analysis, prolonged cardiopulmonary bypass time and prolonged operation time were independent predictive factors of IABP insertion. The postoperative mortality rate was 35.8% and 1% in patients with and without IABP support, respectively (p=0.000). Postoperative renal insufficiency, prolonged ventilatory support, and postoperative atrial fibrillation were independent predictive factors of postoperative mortality in patients with IABP support. The mean follow-up time was 38.55±22.70 months and 48.78±25.20 months in patients with and without IABP support, respectively. The follow-up mortality rate was 3% (n=4) and 5.3% (n=78) in patients with and without IABP support, respectively.
The patients with IABP support had a higher postoperative mortality rate and a longer length of intensive care unit and hospital stay. The mid-term survival was good for patients surviving the early postoperative period.
我们旨在研究影响单纯体外循环冠状动脉旁路移植术(CABG)患者主动脉内球囊反搏(IABP)置入的术前、术中和术后因素。我们还研究了IABP支持患者的发病、死亡和生存相关因素。
2002年1月至2009年12月期间,1657例患者在伊兹密尔卡迪普·切莱比大学阿塔图尔克培训与研究医院接受了单纯CABG手术。需要IABP支持的患者有134例(8.1%)。
在多因素逻辑回归分析中,体外循环时间延长和手术时间延长是IABP置入的独立预测因素。有和没有IABP支持的患者术后死亡率分别为35.8%和1%(p = 0.000)。术后肾功能不全、通气支持时间延长和术后房颤是IABP支持患者术后死亡的独立预测因素。有和没有IABP支持的患者平均随访时间分别为38.55±22.70个月和48.78±25.20个月。有和没有IABP支持的患者随访死亡率分别为3%(n = 4)和5.3%(n = 78)。
接受IABP支持的患者术后死亡率更高,重症监护病房和住院时间更长。术后早期存活的患者中期生存率良好。