Brandrup-Wognsen G, Haglid M, Karlsson T, Berggren H, Herlitz B J
Division of Thoracic and Cardiovascular Surgery Sahlgrenska University Hospital, Göteborg, Sweden.
Thorac Cardiovasc Surg. 1995 Apr;43(2):77-82. doi: 10.1055/s-2007-1013775.
The aim of the study was to describe mortality during a period of two years after coronary artery bypass surgery (CABG) in relation to preoperative risk factors. Included were all the patients in western Sweden in whom CABG was performed between June 1988 and June 1991, without concomitant procedures or re-operations. The study was prospective in design. In all, 2000 patients with a median age of 64 years were operated upon. Early (within 30 days) mortality was 3.0% and late (30-day-2-year) mortality was 4.2%. Total two-year mortality was 7.1%. For patients undergoing coronary artery bypass grafting, the factors found to be independently predictive of early mortality were female sex, renal dysfunction (creatine clearance < 60ml/min), left main stenosis, number of diseased vessels, previous myocardial infarction, and functional class. We found that a history of congestive heart failure, a history of cerebrovascular disease, diabetes mellitus, renal dysfunction and intermittent claudication were independent risk factors for late mortality. In conclusion, with the exception of renal dysfunction, preoperative risk factors for death within 30 days after CABG differ from risk factors for death between 30 days and two years after CABG.
本研究的目的是描述冠状动脉搭桥手术（CABG）后两年内的死亡率及其与术前危险因素的关系。纳入对象为1988年6月至1991年6月间在瑞典西部接受CABG手术、未同时进行其他手术或再次手术的所有患者。本研究采用前瞻性设计。共有2000例患者接受手术，中位年龄为64岁。早期（30天内）死亡率为3.0%，晚期（30天至2年）死亡率为4.2%。两年总死亡率为7.1%。对于接受冠状动脉搭桥术的患者，发现独立预测早期死亡率的因素包括女性、肾功能不全（肌酐清除率<60ml/min）、左主干狭窄、病变血管数量、既往心肌梗死和心功能分级。我们发现，充血性心力衰竭病史、脑血管疾病病史、糖尿病、肾功能不全和间歇性跛行是晚期死亡的独立危险因素。总之，除肾功能不全部位外，CABG术后30天内死亡的术前危险因素与CABG术后30天至两年死亡的危险因素不同。
