冠状动脉搭桥手术患者主动脉内球囊反搏的相关特征、发病率和死亡因素。

Characteristics, morbidity and mortality factors associated with Intra-Aortic Balloon Pump in Coronary Artery Bypass Graft Surgery patients.

作者信息

Shah Sayed Mumtaz Anwar, Awan Nabil I, Jan Azam, Rehman Mujeeb Ur

机构信息

Dr. Sayed Mumtaz Anwar Shah, FCPS. Assistant Professor, Department of Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, Pakistan.

Dr. Nabil I Awan, MBBS. Post-Graduate Resident, Department of Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, Pakistan.

出版信息

Pak J Med Sci. 2020 Sep-Oct;36(6):1318-1324. doi: 10.12669/pjms.36.6.2649.

DOI:10.12669/pjms.36.6.2649

PMID:32968401

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7500997/

Abstract

OBJECTIVE

The aim of our study is to analyze the characteristics, morbidity and mortality of patients requiring an Intra-Aortic Balloon Pump (IABP) in Coronary Artery Bypass Grafting (CABG).

METHODS

An analysis was done on the prospectively collected data of 1216 patients who had CABG in our center between July, 2017 and May, 2019 at our hospital. We categorized patients in to an IABP and non-IABP group on the basis of IABP use. We then compared the pre-operative, per-operative and post-operative characteristics of the two groups. We further stratified the patients according to pre-op ejection fraction (EF).

RESULTS

Out of 1216 patients, 135(11.10%) patients required an IABP. 70(51.9%) patients of IABP group and 699(64.7%) patients of non-IABP group had hypertension (p-value 0.0036). 23.0% had previous myocardial infarction (MI) in the IABP group and 13.8% had prior myocardial infarction (MI) in non-IABP group (p-value 0.0463). Among the patients requiring an IABP, 21(15.5%) of patients had normal EF (>50%) (P-value<0.0001), 72 (53.3%) had EF 35-50%, and 41(30.3%) patients had EF<35% (p-value <0.0001). Mortality of IABP group (19.3%) was greater than non-IABP group (2.4%) (P-value 0.00001).

CONCLUSIONS

Use of IABP increased as the EF decreased. Rate of post-operative stroke, prolonged ICU stay, prolonged ventilation, re-opening due to bleeding and mortality was seen to be significantly higher in the IABP group.

摘要

目的

本研究旨在分析冠状动脉旁路移植术（CABG）中需要主动脉内球囊反搏（IABP）的患者的特征、发病率和死亡率。

方法

对2017年7月至2019年5月在我院中心接受CABG的1216例患者的前瞻性收集数据进行分析。根据IABP的使用情况，将患者分为IABP组和非IABP组。然后比较两组患者的术前、术中及术后特征。我们还根据术前射血分数（EF）对患者进行了进一步分层。

结果

在1216例患者中，135例（11.10%）患者需要IABP。IABP组70例（51.9%）患者和非IABP组699例（64.7%）患者患有高血压（p值0.0036）。IABP组23.0%的患者既往有心肌梗死（MI），非IABP组13.8%的患者既往有心肌梗死（MI）（p值0.0463）。在需要IABP的患者中，21例（15.5%）患者的EF正常（>50%）（P值<0.0001），72例（53.3%）患者的EF为35-50%，41例（30.3%）患者的EF<35%（p值<0.0001）。IABP组的死亡率（19.3%）高于非IABP组（2.4%）（P值0.00001）。