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Anales del Sistema Sanitario de Navarra
versão impressa ISSN 1137-6627
Resumo
NAVARRO GARCIA, MA e DE CARLOS ALEGRE, V. Myocardial revascularization surgery: short and long-term survival analysis. Anales Sis San Navarra [online]. 2021, vol.44, n.1, pp.9-21. Epub 21-Jun-2021. ISSN 1137-6627. https://dx.doi.org/10.23938/assn.934.
Background
This study sets out to describe the survival and clinical evolution of patients who undergo myocardial revascularisation surgery, and identifies the short- and long-term predictive factors for surgical outcomes.
Methods
Study of a cohort of 175 patients undergoing pure or mixed coronary myocardial revascularisation surgery at a heart surgery unit, recruited between 2008 and 2010 and monitored for ten years. Descriptive and logistic regression (OR and 95%CI) analysis were carried out, along with an analysis of survival by Kaplan Meier and Cox uni- and multivariate regression (HR and 95%CI) in the short- (one year) and long-term (ten years).
Results
Predominantly male cohort (85.1%), mean age of 67 years (45-84), and mean EuroSCORE of 5.3%. Mortality was 6.8 and 26.9% at 1 and 10 years, respectively. Mean survival of deceased individuals was 40 months (32.2-47.8). In the short-term, a better NYHA ≤III preoperative functional level was not significantly associated with lower mortality (OR: 0.11; 95%CI: 0.01-1.08; p=0.058), while being female (OR: 2.94; 95%CI: 1.01-8.57; p=0.048) and having a EuroSCORE of >4% (OR: 4.94; 95%CI: 1.52-16.10; p=0.008) showed an increased risk of presenting adverse cardiac events. In the long-term, greater age (HR: 1.06; 95%CI: 1.01-1.10; p=0.026) and lower rates of body mass index after the first postoperative year (HR: 0.90; 95%CI: 0.81-0.99; p=0.040) were independent predictors of mortality.
Conclusion
Age was an independent predictor of long-term mortality, while being female and a EuroSCORE >4% were associated with a higher risk of suffering from short-term cardiovascular events.
Palavras-chave : Coronary artery bypass surgery; Myocardial revascularization; Treatment outcome; Survival; Prognostic factors.