Document Detail


Risk factors for operative mortality in elderly patients undergoing internal mammary artery grafting.
MedLine Citation:
PMID:  7912063     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
From January 1986 through June 1992, 512 elderly patients (70 years and older) underwent internal mammary artery grafting (IMAG). The operative mortality in these patients was 7.62% (39 of 512), which was significantly higher than that (1.97% [60 of 3,047]; p < 0.0001) in younger patients (under 70 years old). To investigate the risk factors in the elderly, the data from the 512 patients were evaluated by univariate analysis and multiple logistic regression. Of 53 variables analyzed, nine preoperative variables (age, smoking history, congestive heart failure, myocardial infarction, New York Heart Association functional class, ejection fraction, left main artery disease, stenosis of the left anterior descending artery, and reoperation), three intraoperative variables (emergency operation, bilateral IMAG, and right IMAG), and nine postoperative variables were significantly associated with the higher mortality (p < 0.05). In particular, the operative mortality was significantly higher in the patients undergoing right IMAG (21.62% [8 of 37]) than that in patients only undergoing left IMAG (6.53% [31 of 475]; p < 0.004). The significant preoperative and intraoperative variables and the variables that have a tendency for correlation (p < 0.2) to mortality were included in a stepwise multiple logistic regression. The regression analysis demonstrated that right IMAG, reoperation, history of myocardial infarction, age, left main artery disease, history of smoking, and postoperative complications are the risk factors for the elderly undergoing IMAG. Therefore, particular care should be taken in those patients scheduled to undergo IMAG. The role of right IMAG in the elderly should be further clarified before universal acceptance of the technique in these patients.
Authors:
G W He; T E Acuff; W H Ryan; M J Mack
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  57     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-07-15     Completed Date:  1994-07-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1453-60; discussion 1460-1     Citation Subset:  AIM; IM    
Affiliation:
Cardiothoracic Surgery Associates of North Texas at Medical City Dallas Hospital.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Coronary Artery Bypass / mortality*
Coronary Disease / pathology,  physiopathology,  surgery
Female
Heart Failure / epidemiology
Hospital Mortality
Humans
Internal Mammary-Coronary Artery Anastomosis
Logistic Models
Male
Multivariate Analysis
Myocardial Infarction / epidemiology
Myocardial Revascularization / mortality*
Postoperative Complications / epidemiology
Risk Factors
Saphenous Vein / transplantation
Smoking / epidemiology
Stroke Volume / physiology
Survival Rate
Texas / epidemiology
Ventricular Function, Left / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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