Validation of a New Classification Method of Postoperative Complications in Patients Undergoing Coronary Artery Surgery.
J Cardiothorac Vasc Anesth
; 30(2): 330-7, 2016 Apr.
Article
en En
| MEDLINE
| ID: mdl-26708697
ABSTRACT
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 MAINRESULTS:
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Algoritmos
/
Vasos Coronarios
/
Procedimientos Quirúrgicos Cardíacos
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Asunto de la revista:
ANESTESIOLOGIA
/
CARDIOLOGIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Finlandia