Hirnle Grzegorz, Stankiewicz Adrian, Mitrosz Maciej, Aboul-Hassan Sleiman Sebastian, Kocańda Szymon, Deja Marek, Rogowski Jan, Cichoń Romuald, Pawliszak Wojciech, Bugajski Paweł, Tobota Zdzisław, Maruszewski Bohdan, Knapik Piotr, Krejca Michał, Cisowski Marek, Hrapkowicz Tomasz
Department of Cardiac Surgery, Medical University of Bialystok, 15-276 Białystok, Poland.
Department of Cardiac Surgery, Zbigniew Religa Heart Center "Medinet", 67-100 Nowa Sol, Poland.
J Clin Med. 2024 Dec 6;13(23):7440. doi: 10.3390/jcm13237440.
The aim of this study was to evaluate the impact of coronary bypass surgery (CABG) on long-term mortality, comparing survival rates to those of the general population in Poland. The study was based on the Polish National Register of Cardiothoracic Surgical Procedures (KROK). Between January 2009 and December 2019, 133,973 patients underwent CABG. The study included all patients who underwent primary CABG. After excluding reoperations and patients with missing key data, there were 132,760 remaining patients who participated in the study. In order to compare patients who underwent CABG with the general population, data from Polish life expectancy tables from the Central Statistical Office (CSO) were used. In the general population (GP), there is a consistent decrease in survival for both women and men throughout the entire observation period. The decline in survivability is more pronounced in the male group. Unlike the CABG group, which is at risk of perioperative mortality, there is no initial drop in survivability in the GP. The early mortality rate in CABG group within 30 days was significantly higher in the group of women than in men (3.51% compared to 2.19%, < 0.001). The annual mortality rate was higher in the group of women (6.7% vs. 5.14%), and survival time was shorter (345.5 ± 0.4 vs. 351.2 ± 0.2 days, < 0.001). However, the total mortality over a 13-year period of observation did not differ significantly between the groups (30.17% for women vs. 29.6% for men, = 0.996) with survival time 10.08 ± 0.02 years in men vs. 10.06 ± 0.03 in women, = 0.996. CABG surgery equalizes the probability of survival between genders. In long-term observation men have a greater survival benefit than women if compared to the predicted survival of the general population. These observations may provide a new perspective on the choice of revascularization strategy in relation to gender.
本研究的目的是评估冠状动脉搭桥手术（CABG）对长期死亡率的影响，并将生存率与波兰普通人群的生存率进行比较。该研究基于波兰心胸外科手术国家登记册（KROK）。在2009年1月至2019年12月期间，133,973例患者接受了CABG手术。该研究纳入了所有接受初次CABG手术的患者。在排除再次手术患者和关键数据缺失的患者后，共有132,760例患者参与了本研究。为了将接受CABG手术的患者与普通人群进行比较，使用了中央统计局（CSO）波兰预期寿命表中的数据。在普通人群（GP）中，在整个观察期内，男性和女性的生存率均持续下降。男性组的生存能力下降更为明显。与有围手术期死亡风险的CABG组不同，普通人群的生存能力没有初始下降。CABG组女性30天内的早期死亡率明显高于男性（分别为3.51%和2.19%，<0.001）。女性组的年死亡率更高（6.7%对5.14%），生存时间更短（分别为345.5±0.4天和351.2±0.2天，<0.001）。然而，在13年的观察期内，两组的总死亡率没有显著差异（女性为30.17%，男性为29.6%，P=0.996），男性的生存时间为10.08±0.02年，女性为10.06±0.0
