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Reoperation for ble...
Reoperation for bleeding following coronary artery bypass surgery with special focus on long-term outcomes
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- Marteinsson, Steinthor A. (författare)
- Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland.
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- Heimisdottir, Alexandra A. (författare)
- Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland.
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- Axelsson, Tomas A. (författare)
- Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland.
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- Johannesdottir, Hera (författare)
- Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland.
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- Arnadottir, Linda O. (författare)
- Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland.
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- Gardarsdottir, Helga R. (författare)
- Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland.
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- Johnsen, Arni (författare)
- Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland.
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- Sigurdsson, Martin, I (författare)
- Landspitali Univ Hosp, Dept Anesthesia & Intens Care, Reykjavik, Iceland.;Univ Iceland, Fac Med, Reykjavik, Iceland.
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- Helgadottir, Solveig (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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- Gudbjartsson, Tomas (författare)
- Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland.;Univ Iceland, Fac Med, Reykjavik, Iceland.
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Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland Landspitali Univ Hosp, Dept Anesthesia & Intens Care, Reykjavik, Iceland.;Univ Iceland, Fac Med, Reykjavik, Iceland. (creator_code:org_t)
- 2020-04-30
- 2020
- Engelska.
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Ingår i: Scandinavian Cardiovascular Journal. - : TAYLOR & FRANCIS LTD. - 1401-7431 .- 1651-2006. ; 54:4, s. 265-273
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objectives: We studied the incidence and risk factors of reoperation for bleeding following CABG in a nationwide cohort with focus on long-term complications and survival.Design: A retrospective study on 2060 consecutive, isolated CABG patients operated 2001-2016. Outcome of reoperated patients (n = 130) were compared to non-reoperated ones (n = 1930), including major adverse cardiac and cerebrovascular events (MACCE) and overall survival. Risk factors for reoperation were determined using multivariate logistic regression and a Cox proportional hazards model to assess prognostic factors of long-term survival. Median follow-up was 7.6 years.Results: One hundred thirty patients (6.3%) were reoperated with an annual decrease of 4.1% per year over the study period (p=.04). Major complications (18.5 vs. 9.6%) and 30-day mortality (8.5 vs. 1.9%,) were higher in the reoperation group (p<.001). The use of clopidogrel preoperatively (OR 3.62, 95% CI: 1.90-6.57) and reduced left ventricular ejection fraction (OR 2.23, 95% CI: 1.25-3.77) were the strongest predictors of reoperation, whereas off-pump surgery was associated with a lower reoperation risk (OR 0.44, 95% CI: 0.22-0.85). After exluding patients that died within 30 days postoperatively, no difference in long-term survival or freedom from MACCE was found between groups, and reoperation was not an independent risk factor for long-term mortality in multivariate analysis.Conclusions: The reoperation rate in this study was relatively high but decreased significantly over time. Reoperation was associated with twofold increased risk for major complications and fourfold 30-day mortality, but comparable long-term MACCE and survival rates. This implies that if patients survive the first 30 days following reoperation, their long-term outcome is comparable to non-reoperated patients.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Coronary artery bypass grafting (CABG)
- reoperation for bleeding
- complications
- risk factors
- 30-day mortality
- survival
- long-term outcome
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