Pre-operative, Intraoperative, and Post-operative Determinants Associated with 30-day Mortality Post-Coronary Artery Bypass Graft: A Retrospective Cohort Study (original) (raw)

2022, Open Access Macedonian Journal of Medical Sciences

BACKGROUND: Various determinants of 30-day mortality risk in CABG patients have been formulated into certain scoring models such as the EuroSCORE and ACEF model. However, these models only consider pre-operative parameters while excluding intraoperative, post-operative, and perioperative parameters. At present, the prior research has increasingly emphasized the role of these excluded parameters as determinants of post-CABG mortality. Furthermore, there are differences in mortality rate of CABG procedures in Indonesia when compared with other countries. AIM: This study aimed to identify pre-operative, intraoperative, and post-operative determinants of 30-day mortality after CABG surgery in Indonesian population. METHODS: In this retrospective cohort study, secondary data were obtained from the medical records of 263 patients aged ≥ 18 years who underwent CABG at a single center in Indonesia during the year 2012-2015. Selected preoperative, intraoperative, post-operative, and perioperative determinants were analyzed in both bivariate and multivariate Cox regression models to identify determinants associated with 30-day mortality. RESULTS: The 30-day mortality rate after CABG was 11.8%. Multivariate analysis identified neurological dysfunction (HR 6.16; 95% CI 2.42-15.66), renal impairment (HR 3.9; 95% CI 1.46-10.38), left ventricle dysfunction (HR 3.53;95% CI 1.55-8.03), aortic clamp duration (HR 3.7;95% CI 1.53-8.96), surgery duration (HR 3.85;95% CI 1.39-10.70), post-operative thrombocytopenia (HR 3.99;95% CI 1.72-9.23), and post-operative intra-aortic balloon pump (HR 10.98; 95% CI 4.77-25.28) as significant determinants associated with 30-day mortality after CABG CONCLUSION: Neurological dysfunction, renal impairment, left ventricle dysfunction, aortic clamp duration, surgery duration, post-operative thrombocytopenia, and post-operative intra-aortic balloon pump were independent determinants for 30-day mortality after CABG.