20 мая 2002 00:00 |
Hospital readmission after coronary artery bypass grafting: are women doing worse?
Background. In studies of gender effects on outcome after coronary artery bypass grafting, early mortality has consistently tended to be higher among women, whereas
Methods. Between 1987 and 1996, 7,493 patients were discharged alive after primary coronary artery bypass grafting and were followed up to the first readmission, date of death, or December 31, 1996. The hazard ratios for the risk factors found were used to calculate a readmission risk score.
Results. A total of 4,780 (63.8%) patients were readmitted. The fraction not readmitted within 1, 5, and 10 years were 61%, 29%, and 14% (95% confidence intervals = 60 to 62, 28 to 30, and 12 to 16), respectively. The risk of readmission was highest early after operation and then gradually decreased. Older age, active smoking, diabetes, previous myocardial infarction, unstable angina, dyspnea, severe left ventricular dysfunction, advanced New York Heart Association functional class, bypass time of 2 hours or more, and length of stay all independently increased the risk of readmission. Female sex was a significant risk factor in univariate but not in multivariate analysis. In all age groups, women had a one unit higher risk score. Given the same risk score, the risk of readmission was similar between sexes.
Conclusions. This study showed an acceptable risk of readmission after coronary artery bypass grafting. Women more often had risk factors related to readmission. However, given identical disease severity, the risk was similar in men and women.
20 мая 2002 | 00:05Effects of skeletonization on intraoperative flow and anastomosis diameter of internal thoracic arteries in coronary artery bypass grafting
Background. We examined the hypothesis that complete skeletonization of an internal thoracic artery (ITA) results in increased diameter of the graft for anastomosis and therefore improves graft
20 мая 2002 | 00:05Intraoperative evaluation of coronary anastomosis by transit-time ultrasonic flow measurement
Background. Intraoperative assessment of the anastomosis is important during coronary bypass on a beating heart. The purpose of this study is to predict the quality of anastomosis using transit-time
20 мая 2002 | 00:05Coronary end-to-side sleeve anastomosis using adhesive in off-pump bypass grafting in the pig
Background. In the exploration of facilitated coronary anastomosis strategies, we assessed a new octyl-cyanoacrylate adhesive in combination with a modified end-to-side sleeve anastomosis in off-pump
20 мая 2002 | 00:05Repetitive atrial flutter as a complication of the left-sided simple maze procedure
Background. Of 41 patients who had undergone a left-sided simple maze procedure, 4 (9.8%) developed repetitive tachycardia due to atrial flutter, and required radiofrequency catheter ablation.
20 мая 2002 | 00:05Hemodynamic stability during 17 years of the Carpentier-Edwards aortic pericardial bioprosthesis
Background. Long-term stability of the hemodynamic performance of commercially available Carpentier-Edwards stented bovine pericardial aortic bioprostheses (Perimount RSR) is unknown. To anticipate