30-day mortality after coronary artery bypass grafting and valve surgery has greatly improved over the last decade, but the 1-year mortality remains constant.
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Date
2015-04
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Abstract
Introduction: European system for cardiac operative risk evaluation (EuroSCORE) is a valuable tool in
control of the quality of cardiac surgery. However, the validity of the risk score for the individual patient may
be questioned. The present study was carried out to investigate whether the continued fall in short‑term
mortality reflects an actual improvement in late mortality, and subsequently, to investigate EuroSCORE as
predictor of 1‑year mortality. Methods: A population‑based cohort study of 25,602 patients from a 12‑year
period from three public university hospitals undergoing coronary artery bypass grafting (CABG) or valve
surgery. Analysis was carried out based on EuroSCORE, age and co‑morbidity factors (residual EuroSCORE).
Results: During the period the average age increased from 65.1 ± 10.0 years to 68.9 ± 10.7 years (P < 0.001,
one‑way ANOVA), and the number of females increased from 26.0% to 28.2% (P = 0.0012, Chi‑square test).
The total EuroSCORE increased from 4.67 to 5.68 while the residual EuroSCORE decreased from 2.64 to
1.83. Thirty‑day mortality decreased from 4.07% in 1999–2000 to 2.44% in 2011–2012 (P = 0.0056; Chi‑square
test), while 1‑year mortality was unchanged (6.50% in 1999–2000 vs. 6.25% in 2011–2012 [P = 0.8086;
Chi‑square test]). Discussion: The study demonstrates that both co‑morbidity and age has a great impact
on 30‑day mortality. However, with time the impact of co‑morbidity seems less. Thus, age is more important
than co‑morbidity in late mortality. The various developments in short and long‑term mortality are not readily
explained. Conclusion: Although 30‑day mortality of CABG and valve surgery patients has decreased during
the 12‑year period, the 1‑year mortality remains the same.
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Keywords
Cardiac surgery, Coronary artery bypass grafting, European system for cardiac operative risk evaluation, Risk factor
Citation
Hansen Laura Sommer, Hjortdal Vibeke Elisabeth, Andreasen Jan Jesper, Mortensen Poul Erik, Jakobsen Carl-Johan. 30-day mortality after coronary artery bypass grafting and valve surgery has greatly improved over the last decade, but the 1-year mortality remains constant. Annals of Cardiac Anaesthesia. 2015 Apr; 18(2): 138-142.