Preoperative prediction of long-term survival after coronary artery bypass grafting in patients with low left ventricular ejection fraction
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Ημερομηνία
Συγγραφείς
DeRose, J. J., Jr.
Toumpoulis, I. K.
Balaram, S. K.
Ioannidis, J. P.
Belsley, S.
Ashton, R. C., Jr.
Swistel, D. G.
Anagnostopoulos, C. E.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
J Thorac Cardiovasc Surg
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
OBJECTIVE: We aimed to develop multivariable models of preoperative risk factors that predict long-term survival after coronary artery bypass grafting in patients with ejection fraction 25% or less. METHODS: We retrospectively evaluated 544 consecutive patients with ejection fraction 25% or less who underwent coronary artery bypass grafting from 1992 to 2002 at a single institution. Long-term survival data (mean follow-up 4.1 years) were obtained from the National Death Index. Multivariable Cox regression analysis was performed to construct a predictive score for long-term mortality. A split-sample approach was also used building a model on a training group (n = 360); this model was then tested on a separate validation group (n = 184). RESULTS: From the entire database, the predictive score was calculated according to the following equation: 0.430(if past congestive heart failure) + 0.049(age in years) + 0.507(if peripheral vascular disease) + 0.580(if emergency operation) + 0.366(if chronic obstructive pulmonary disease). The 5-year survivals of the predictive score quartiles were 82.3%, 78.2%, 65.5%, and 45.5% (P < .0001). The model based on the training group had four independent predictors for long-term mortality (the same as the listed equation except for past congestive heart failure). The 5-year survival rates of the quartiles were 90.1%, 75.4%, 64.3%, and 49.2% in the training group (P < .0001) and 77.4%, 71.2%, 65.8%, and 45.5% in the validation group (P = .0001). CONCLUSION: Coronary artery bypass grafting in patients with severe ischemic cardiomyopathy achieves satisfactory midterm and long-term survival in selected patients. This new score, which is based on long-term data from a large number of patients, may aid clinicians in selecting therapeutic interventions for patients with ischemic cardiomyopathy.
Περιγραφή
Λέξεις-κλειδιά
Aged, *Coronary Artery Bypass, Coronary Artery Disease/*mortality/*physiopathology/surgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Multivariate Analysis, New York/epidemiology, Postoperative Complications/etiology/mortality, Predictive Value of Tests, *Preoperative Care, Retrospective Studies, Stroke Volume/*physiology, Survival Analysis, Time Factors, Treatment Outcome, Ventricular Function, Left/*physiology
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/15678041
http://ac.els-cdn.com/S0022522304008736/1-s2.0-S0022522304008736-main.pdf?_tid=caa941c0a460dbe2d3aef79e495094f2&acdnat=1333364368_3cd3eea842f1631a7881d88e71456db9
http://ac.els-cdn.com/S0022522304008736/1-s2.0-S0022522304008736-main.pdf?_tid=caa941c0a460dbe2d3aef79e495094f2&acdnat=1333364368_3cd3eea842f1631a7881d88e71456db9
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής