24-Hour in-hospital mortality predictions in coronary artery bypass grafting patients
Background. The purpose of this study was to determine the factors that can help predict risk of mortality in the first 24 h of coronary artery bypass grafting (CABG), because mortality within a few hours of surgery is a disastrous event for surgeons and the patient's family. Methods. The study population consisted of 120 in-hospital mortality cases (1.07%) from 11,183 patients who underwent CABG from February 2002 to February 2006 by the same group of surgeons in a referral center. One group consisted of 40/120 (about 33.3%) patients who died during the first 24 h after surgery. The second group consisted of 80/120 patients (66.7%) who died between the 2(nd) and 30(th) day postoperatively. A set of data was gathered from the surgery database of the hospital and analyzed in a univariate model. Results. Among the studied variables, only the following factors proved to be significant: previous percutaneous transluminal coronary angioplasty (PTCA), previous cerebrovascular accident (CVA), cardiopulmonary bypass (CBP) time, and postoperative atrial fibrillation (AF) (p <= 0.05). Conclusions. This study revealed that influencing factors in 24-h in-hospital mortality are previous PTCA, previous CVA, CBP time, and postoperative AF. It is interesting that influencing factors in global 30-day hospital mortality such as body mass index, diabetes mellitus, preoperative arrhythmia, ejection fraction, history of previous CABG and resuscitation, or catastrophic states like poor runoff coronary vessels, triple vessel disease or associated procedures like valve surgery were not significant in the first 24-h mortality when comparing with in-hospital mortality in this study. (C) 2007 IMSS. Published by Elsevier Inc.