Intraoperative physiologic variables and outcome in cardiac surgery: Part I. In-hospital mortality.

Published

Journal Article

BACKGROUND: Risk stratification schemes have been developed to predict outcome of coronary artery bypass grafting (CABG) procedures, which are predominately based upon unalterable preoperative patient characteristics. The purpose of this study was to determine if minimum intraoperative hematocrit, maximum glucose concentration, mean arterial pressure on cardiopulmonary bypass, or duration of bypass influence risk-adjusted in-hospital mortality after CABG. METHODS: Outcome data from 2,862 CABG patients were merged with intraoperative physiologic data. A preoperative mortality risk index was calculated for each patient. Variables found significant (p<0.05) by univariate logistic regression were tested in a multiple variable model to determine risk-adjusted association with mortality. RESULTS: Overall mortality rate was 1.85%. The preoperative risk index was significantly associated with mortality (p = 0.0001). No significant association was present between mortality and intraoperative variables. Preexisting hypertension was an independent predictor of mortality after controlling for risk index and bypass duration. CONCLUSIONS: Preexisting hypertension proved to be an independent predictor of mortality in our patient population. This study found no evidence to support the hypothesis that mean arterial pressure less than 50 mm Hg, lower hematocrit, or elevated glucose while on bypass increases in-hospital mortality.

Full Text

Duke Authors

Cited Authors

  • Hill, SE; van Wermeskerken, GK; Lardenoye, JW; Phillips-Bute, B; Smith, PK; Reves, JG; Newman, MF

Published Date

  • April 2000

Published In

Volume / Issue

  • 69 / 4

Start / End Page

  • 1070 - 1075

PubMed ID

  • 10800796

Pubmed Central ID

  • 10800796

International Standard Serial Number (ISSN)

  • 0003-4975

Digital Object Identifier (DOI)

  • 10.1016/s0003-4975(99)01442-3

Language

  • eng

Conference Location

  • Netherlands