Coronary Artery Bypass Grafting: 30-Day Operative Morbidity Analysis in 1046 Patients

Abstract

Background: To determine the rate and risk factors of three operative complications (renal failure, pneumonia, and sternal wound infection) within 30 days after isolated coronary artery bypass surgery.

Methods: Medical records of 1,046 consecutive patients between the years 2005 and 2009 were reviewed. Demographic data and peri-operative information were collected and analyzed. Univariate and multivariate analysis between different variables were performed.

Results: Of all patients 3.6% developed pneumonia, 5.9% developed acute renal failure and 8.5% developed sternal wound infection. Independent predictors of acute renal failure were age > 65 years (P = 0.030), pre-operative renal impairment (P < 0.005), peripheral vascular disease (P = 0.005), emergency surgery (P = 0.043), blood transfusion (P = 0.002) mechanical ventilation > 12 hours (P < 0.005) and prolonged inotropic support (P = 0.035). Pneumonia independent predictors were female gender (P < 0.005), diabetes mellitus (P = 0.024), peripheral vascular disease (P = 0.012), emergency surgery (P = 0.007), blood transfusion (P = 0.001), mechanical ventilation > 12 hours (P = 0.005) and prolonged inotropic support (P < 0.005). Sternal wound infection independent predictors were diabetes mellitus (P = 0.017), intra- and post-operative blood transfusion (P < 0.005), and prolonged inotropic support (P = 0.006).

Conclusion: Age, female gender, history of diabetes mellitus, chronic obstructive pulmonary disease, peripheral vascular disease, renal impairment, emergency surgery, per-operative blood transfusion, mechanical ventilation > 12 hours and prolonged inotropic support are associated with the 30-day complication after on-pump isolated coronary artery bypass grafting surgery.




doi:10.4021/jocmr1020w