Suttorp M J, Kingma J H, Koomen E M, Tijssen J G, Defauw J A, Ernst J M
Ned Tijdschr Geneeskd. 1989 Dec 9;133(49):2441-5.
In 1986, 1124 patients were selected for coronary artery bypass surgery (CABG). Of patients in line for CABG 25 (2.2%) died of a cardiac cause before operation. This complies with a cardiac mortality risk of 8.3 patients per 100 patient years follow-up. To assess patient characteristics predictive for early mortality before surgery, 25 deceased patients were analysed and compared with 50 controls matched by age, gender, type of surgery and priority. Using multivariate analysis, cardiac enlargement on chest X-ray, positive exercise testing with short duration (less than 6 minutes), smoking, coumarin treatment, unstable angina just prior to angiography and left main or three-vessel disease were independent predictors for death while waiting for CABG. We conclude that patients with the above mentioned characteristics have an increased short term mortality while waiting for CABG. These indicators may contribute important information for determination of priority in patients at high risk while waiting for CABG.
1986年,1124例患者被选作冠状动脉搭桥手术(CABG)。在等待CABG的患者中,有25例(2.2%)在手术前死于心脏病因。这相当于每100患者年随访中有8.3例患者的心脏死亡风险。为了评估术前早期死亡的预测性患者特征,对25例死亡患者进行了分析,并与50例年龄、性别、手术类型和优先级相匹配的对照患者进行了比较。采用多变量分析,胸部X线片显示心脏扩大、运动试验阳性且持续时间短(少于6分钟)、吸烟、香豆素治疗、血管造影前不稳定型心绞痛以及左主干或三支血管病变是等待CABG期间死亡的独立预测因素。我们得出结论,具有上述特征的患者在等待CABG期间短期死亡率增加。这些指标可能为确定等待CABG的高危患者的优先级提供重要信息。