Prognostic Impact of Prolonged Cross-Clamp Time in Coronary Artery Bypass Grafting
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Prognostic Impact of Prolonged Cross-Clamp Time in Coronary Artery Bypass Grafting. / Ruggieri, Vito G; Bounader, Karl; Verhoye, Jean Philippe; Onorati, Francesco; Rubino, Antonino S; Gatti, Giuseppe; Tauriainen, Tuomas; De Feo, Marisa; Reichart, Daniel; Dalén, Magnus; Svenarud, Peter; Faggian, Giuseppe; Santarpino, Giuseppe; Maselli, Daniele; Gherli, Riccardo; Mariscalco, Giovanni; Salsano, Antonio; Nicolini, Francesco; Gherli, Tiziano; Saccocci, Matteo; Airaksinen, Juhani K E; Chocron, Sidney; Perrotti, Andrea; Biancari, Fausto.
in: HEART LUNG CIRC, Jahrgang 27, Nr. 12, 12.2018, S. 1476-1482.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Prognostic Impact of Prolonged Cross-Clamp Time in Coronary Artery Bypass Grafting
AU - Ruggieri, Vito G
AU - Bounader, Karl
AU - Verhoye, Jean Philippe
AU - Onorati, Francesco
AU - Rubino, Antonino S
AU - Gatti, Giuseppe
AU - Tauriainen, Tuomas
AU - De Feo, Marisa
AU - Reichart, Daniel
AU - Dalén, Magnus
AU - Svenarud, Peter
AU - Faggian, Giuseppe
AU - Santarpino, Giuseppe
AU - Maselli, Daniele
AU - Gherli, Riccardo
AU - Mariscalco, Giovanni
AU - Salsano, Antonio
AU - Nicolini, Francesco
AU - Gherli, Tiziano
AU - Saccocci, Matteo
AU - Airaksinen, Juhani K E
AU - Chocron, Sidney
AU - Perrotti, Andrea
AU - Biancari, Fausto
N1 - Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
PY - 2018/12
Y1 - 2018/12
N2 - BACKGROUND: The prognostic impact of cross-clamp time (XCT) in patients undergoing isolated coronary artery bypass grafting (CABG) has not been thoroughly investigated.MATERIAL AND METHODS: 2957 patients who underwent on-pump isolated CABG from the prospective multicentre E-CABG study were the subjects of this analysis.RESULTS: The mean XCT in this series was 58±25minutes Cross-clamp time was >60 minutes in 1134 patients (38.3%), >75minutes in 619 patients (20.9%) and >90minutes in 296 patients (10.0%). Multivariate analysis showed that XCT was an independent predictor of 30-day mortality (p<0.0001, OR 1.027, 95%CI 1.015-1.039) along with age (p<0.0001), female gender (p=0.001), pulmonary disease (p=0.001), poor mobility (p=0.002), urgency status (p=0.007), critical preoperative status (p=0.002) and participating centres (p=0.015). Adjusted risk of 30-day mortality was highest for XCT >75minutes (2.9% vs. 1.7%, p=0.002, OR 3.479, 95%CI 1.609-7.520). Analysis of 428 propensity score matched pairs showed that XCT >75minutes was associated with significantly increased risk of early mortality, prolonged use of inotropes, postoperative use of intra-aortic balloon pump, use of extracorporeal membrane oxygenation, atrial fibrillation, prolonged stay in the intensive care unit and of composite major adverse events.CONCLUSIONS: Isolated CABG is currently performed with prolonged XCT in a significant number of patients and this seems to be a determinant of poor early outcome.
AB - BACKGROUND: The prognostic impact of cross-clamp time (XCT) in patients undergoing isolated coronary artery bypass grafting (CABG) has not been thoroughly investigated.MATERIAL AND METHODS: 2957 patients who underwent on-pump isolated CABG from the prospective multicentre E-CABG study were the subjects of this analysis.RESULTS: The mean XCT in this series was 58±25minutes Cross-clamp time was >60 minutes in 1134 patients (38.3%), >75minutes in 619 patients (20.9%) and >90minutes in 296 patients (10.0%). Multivariate analysis showed that XCT was an independent predictor of 30-day mortality (p<0.0001, OR 1.027, 95%CI 1.015-1.039) along with age (p<0.0001), female gender (p=0.001), pulmonary disease (p=0.001), poor mobility (p=0.002), urgency status (p=0.007), critical preoperative status (p=0.002) and participating centres (p=0.015). Adjusted risk of 30-day mortality was highest for XCT >75minutes (2.9% vs. 1.7%, p=0.002, OR 3.479, 95%CI 1.609-7.520). Analysis of 428 propensity score matched pairs showed that XCT >75minutes was associated with significantly increased risk of early mortality, prolonged use of inotropes, postoperative use of intra-aortic balloon pump, use of extracorporeal membrane oxygenation, atrial fibrillation, prolonged stay in the intensive care unit and of composite major adverse events.CONCLUSIONS: Isolated CABG is currently performed with prolonged XCT in a significant number of patients and this seems to be a determinant of poor early outcome.
KW - Aged
KW - Coronary Artery Bypass/methods
KW - Europe/epidemiology
KW - Female
KW - Follow-Up Studies
KW - Hospital Mortality/trends
KW - Humans
KW - Incidence
KW - Male
KW - Myocardial Ischemia/surgery
KW - Postoperative Complications/epidemiology
KW - Prognosis
KW - Propensity Score
KW - Prospective Studies
KW - Risk Factors
KW - Survival Rate/trends
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1016/j.hlc.2017.09.006
DO - 10.1016/j.hlc.2017.09.006
M3 - SCORING: Journal article
C2 - 29276146
VL - 27
SP - 1476
EP - 1482
JO - HEART LUNG CIRC
JF - HEART LUNG CIRC
SN - 1443-9506
IS - 12
ER -