Validation of a New Classification Method of Postoperative Complications in Patients Undergoing Coronary Artery Surgery

被引：5

作者：

Kinnunen, Eeva-Maija ^{[1
]}

Mosorin, Matti-Aleksi ^{[1
]}

Perrotti, Andrea ^{[2
]}

Ruggieri, Vito G. ^{[3
]}

Svenarud, Peter ^{[4
]}

Dalen, Magnus ^{[5
]}

Onorati, Francesco ^{[6
]}

Faggian, Giuseppe ^{[6
]}

Santarpino, Giuseppe ^{[7
]}

Meselli, Daniele ^{[7
]}

Dominici, Carmelo ^{[7
]}

Nardella, Saverio ^{[7
]}

Musumeci, Francesco ^{[8
]}

Gherli, Riccardo ^{[8
]}

Mariscalco, Giovanni ^{[9
]}

Masala, Nicola ^{[9
]}

Rubino, Antonino S. ^{[10
]}

Mignosa, Carmelo ^{[10
]}

De Feo, Marisa ^{[11
]}

Della Corte, Alessandro ^{[11
]}

Bancone, Ciro ^{[11
]}

Chocron, Sidney ^{[2
]}

Gatti, Giuseppe ^{[2
,12
]}

Juvonen, Tatu ^{[1
]}

Biancari, Fausto ^{[1
]}

机构：

[1] Oulu Univ Hosp, POB 21, Oulu 90029, Finland

[2] Pontchaillou Univ Hosp, Div Cardiothorac & Vasc Surg, Rennes, France

[3] Univ Hosp Jean Minjoz, Dept Thorac & Cardiovasc Surg, Besancon, France

[4] Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Dept Cardiothorac Surg & Anesthesiol, Stockholm, Sweden

[5] Verona Univ Hosp, Div Cardiovasc Surg, Verona, Italy

[6] Paracelsus Med Univ, Dept Cardiac Surg, Klinikum Nurnberg, Nurnberg, Germany

[7] St Anna Hosp, Dept Cardiac Surg, Catanzaro, Italy

[8] Hosp S Camillo Forlanini, Dept Cardiosci, Unit Cardiac Surg, Row, Italy

[9] Univ Leicester, Glenfield Hosp, Dept Cardiovasc Sci, Clin Sci Wing, Leicester, Leics, England

[10] Ctr Cuore Morgagni, Pedara, Italy

[11] Univ Naples 2, Dept Cardiothorac Sci, Div Cardiac Surg, Naples, Italy

[12] Osped Riuniti, Div Cardiac Surg, Trieste, Italy

来源：

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA | 2016年 / 30卷 / 02期

关键词：

coronary artery bypass grafting; cardiac surgery; complication; classification; BYPASS GRAFT-SURGERY; ACUTE KIDNEY INJURY; CARDIAC-SURGERY; GASTROINTESTINAL COMPLICATIONS; SURGICAL COMPLICATIONS; MORTALITY; COST; RISK; TRANSFUSION; MORBIDITY;

D O I：

10.1053/j.jvca.2015.09.019

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Objective: The authors aimed to validate the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) classification of postoperative Complications in patients undergoing coronary artery bypass grafting (CABG). Design: Retrospective, observational study. Setting: University hospital. Participants: A total of 2,764 patients with severe coronary artery disease. Complete baseline, operative, and postoperative data were available for patients who underwent isolated CABG. Interventions: Isolated CABG. Measurements and Main Results: The E-CABG complication classification was used to stratify the severity and prognostic impact of adverse postoperative events. Primary outcome endpoints were 30-day, 90-day, and long-term all cause mortality. The secondary outcome endpoints was the length of intensive care unit stay. Both the E-CABG complication grades and additive score were predictive of 30-day (area under the receiver operating characteristics curve 0.866, 95% confidence interval [CI] 0.829-0.903; and 0.876; 95% CI 0.844-0.908, respectively) and 90-day (area under the receiver operating characteristics curve 0.850, 95% CI 0.812-0.887; and 0.863, 95% CI 0.829-0.897, respectively) all-cause mortality. The complication grades were independent predictors of increased mortality at actuarial (log-rank: p < 0.0001) and adjusted analysis (p < 0.0001; grade 1: hazard ratio [HR] 1.757, 95% CI 1.111-2.778; grade 2: HR 2.704, 95% CI 1.664-4.394; grade 3: HR 5.081, 95% CI 3.148-8.201). When patients who died within 30 days were excluded from the analysis, this grading method still was associated with late mortality (p < 0.0001). The grading method (p < 0.0001) and the additive score (rho, 0.514; p < 0.0001) were predictive of the length of intensive care unit stay. Conclusions: The E-CABG postoperative complication classification seems to be a promising tool for stratifying the severity and prognostic impact of postoperative complications in patients undergoing cardiac surgery. (C) 2016 Elsevier Inc. All rights reserved.

引用

页码：330 / 337

页数：8

共 21 条

[1]

[Anonymous], EUR J CARDIOTHORAC S

[2] Intraaortic balloon pump in open heart operations: 10-year follow-up with risk analysis [J].