Yumun Gunduz, Aydin Ufuk, Ata Yusuf, Toktaş Faruk, Pala Arda Aybars, Ozyazicioglu Ahmet Fatih, Turk Tamer, Yavuz Senol
Cardiovasc J Afr. 2015 May-Jun;26(3):130-3.
The mortality rate in coronary artery bypass surgery increases with advancing patient age. This study was conducted to analyse and compare older (above 65 years of age) with younger patients (below 65 years of age) who had undergone coronary artery bypass surgery and had an intra-aortic balloon pump (IABP) inserted, comparing hospital stay, clinical features, intensive care unit stay, postoperative complications, and morbidity and mortality rates.
One hundred and ninety patients who had undergone coronary artery bypass surgery and required IABP support were enrolled in this study. Patients younger than 65 years of age were considered young, and the others were considered old. Ninety-two patients were young and 98 were old. The mortality rates, pre-operative clinical characteristics, postoperative complications, and duration of intensive care unit and hospital stays of the groups were compared. The risk factors for mortality and complications were analysed.
One hundred and thirty-eight of the patients were male, and the mean patient age was 62.7 ± 9.9 years. The mortality rate was higher in the older patient group than the younger group [34 (37.7%) and 23 (23.4 %), respectively (p = 0.043)]. The cross-clamp time, mean ejection fraction, cardiopulmonary bypass time, and length of stay in the intensive care unit were similar among the groups (p > 0.05). Cardiopulmonary bypass time was the single independent risk factor for mortality in both groups.
In this study, high mortality rates in the postoperative period were similar to prior studies regarding IABP support. The complication rates were higher in the older patient group. Prolonged cardiopulmonary bypass and advanced age were determined to be significant risk factors for mortality.
冠状动脉搭桥手术的死亡率随患者年龄增长而增加。本研究旨在分析和比较接受冠状动脉搭桥手术并植入主动脉内球囊反搏（IABP）的老年患者（65岁以上）和年轻患者（65岁以下），比较住院时间、临床特征、重症监护病房停留时间、术后并发症以及发病率和死亡率。
190例接受冠状动脉搭桥手术并需要IABP支持的患者纳入本研究。年龄小于65岁的患者被视为年轻患者，其他患者被视为老年患者。年轻患者92例，老年患者98例。比较两组的死亡率、术前临床特征、术后并发症以及重症监护病房和住院时间。分析死亡率和并发症的危险因素。
138例患者为男性，患者平均年龄为62.7±9.9岁。老年患者组的死亡率高于年轻患者组[分别为34例（37.7%）和23例（23.4%）（p = 0.043）]。两组间的阻断时间、平均射血分数、体外循环时间和重症监护病房停留时间相似（p > 0.05）。体外循环时间是两组死亡率的单一独立危险因素。
在本研究中，术后高死亡率与先前关于IABP支持的研究相似。老年患者组的并发症发生率更高。体外循环时间延长和年龄较大被确定为死亡率的重要危险因素。
