scholarly journals Functional Status May Serve as a Predictor of CABG Surgery Outcome in the Elderly Patient

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Chantal Mayer ◽  
Jean-François Morin
Keyword(s):  
High Risk ◽  
Elderly Patients ◽  
Functional Status ◽  
Artery Bypass ◽  
Bypass Graft ◽  
The Elderly ◽  
Limiting Factor ◽  
Mortality And Morbidity ◽  
Cabg Surgery ◽  
Surgery Outcome

Despite the growing number of elderly patients undergoing coronary artery bypass graft (CABG) surgery, no study addressing postoperative outcome from the perspective of preoperative functional status has been reported to date. The present investigation therefore undertook to determine, among elderly individuals matched for cardiac status, whether patients with poor functional status have a greater risk of mortality and morbidity following CABG surgery than those with good functional status. Retrospective preoperative and postoperative geriatric functional assessment using a standardized questionnaire was performed on 46 consecutive patients who had undergone CABG in 1994 at age 65 or older. Preoperative functional status was comprised of pre-anginal functional status (before angina limited physical activity) and anginal functional status (during which angina was a noticeable limiting factor). CABG outcome was recorded in terms of postoperative assessment of functional status, morbidity, and mortality. The results of statistical analysis revealed that both pre-anginal and anginal functional status were sensitive predictors of post-operative functional status (p < 0.005 and p < 0.001, respectively). In addition, the presence of comorbidities typically used in the screening of candidates was found to be a sensitive predictor of outcome (p < 0.02). However, the presence of comorbidities was not significantly linked to poor preoperative functional status (p > 0.05), indicating that these two predictors may screen for different elderly sub-populations at high risk for negative outcome of CABG. If confirmed by further studies of elderly patients undergoing CABG, these results suggest a new and important role for functional status as a predictor of CABG outcome in the elderly. Furthermore, these results may be useful toward the development of a reliable tool in screening for high risk of poor outcome among elderly candidates for CABG surgery. 

scholarly journals Prognostic Value of Procalcitonin for Morbidity and Mortality in Patients after Cardiac Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ahmad Amouzeshi ◽  
Farshid Abedi ◽  
Mahmoud Zardast ◽  
Yaser Rezaeian Bilondi ◽  
Zahra Amouzeshi
Keyword(s):  
Mortality Rate ◽  
Wound Infection ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Early Mortality ◽  
Morbidity And Mortality ◽  
Mortality And Morbidity ◽  
Cabg Surgery ◽  
One Year ◽  
Cabg Patients

Background. The increased serum procalcitonin (PCT) level in cardiac patients is known as a sign of postoperative complications. Objective. Considering the importance of predicting the incidence of both complications and mortality caused by coronary artery bypass graft (CABG) surgery, this study was conducted to determine the serum PCT level and its relationship with one-year morbidity and mortality among CABG patients. Methods. This descriptive-analytical study was performed on 100 patients who underwent CABG surgery in Vali-e-Asr Hospital of Birjand, Iran. They were selected by a census sampling method from March 2014 to March 2015. The Elecsys BRAHMS PCT kit (Roche Company) was then used to measure the patients’ serum PCT level. The required data were collected using the patients’ medical records and telephone interviews with the patient or his/her relatives by passing one year from their discharge. The outcomes of this study comprised of mortality and morbidity causes (e.g., dysrhythmia, infection, and stroke). The data were then analyzed in SPSS version 16 by Mann–Whitney, chi-squared, and Fisher exact tests. Results. The postoperative serum PCT level is significantly correlated with sternum wound infection ( p = 0.001 ), packed cells (PC) transfusion ( p = 0.003 ), and death ( p = 0.003 ). In addition, a significant relationship was found between dyslipidemia and hypertension and early mortality rate in patients with high levels of PCT. Of note, risk-adjusted death did not differ significantly between the serum PCT levels after one year (RR, 0.068; 95% CI 0.008–0.566). Conclusion. Higher PCT serum levels in CABG patients are associated with the increased early mortality rate, sternum wound infection, and PC transfusion. Additionally, the other factors associated with mortality in the patients under study included dyslipidemia and hypertension.

Cognitive and functional status predictors of delirium and delirium severity after coronary artery bypass graft surgery: an interim analysis of the Neuropsychiatric Outcomes After Heart Surgery study

2015 ◽  
Vol 27 (12) ◽  
pp. 1929-1938 ◽  
Author(s):  
Mark A. Oldham ◽  
Keith A. Hawkins ◽  
David D. Yuh ◽  
Michael L. Dewar ◽  
Umer M. Darr ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Functional Status ◽  
Coronary Artery Bypass ◽  
Functional Impairment ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Cabg Surgery

ABSTRACTBackground:Cognitive and functional impairment increase risk for post-coronary artery bypass graft (CABG) surgery delirium (PCD), but how much impairment is necessary to increase PCD risk remains unclear.Methods:The Neuropsychiatric Outcomes After Heart Surgery (NOAHS) study is a prospective, observational cohort study of participants undergoing elective CABG surgery. Pre-operative cognitive and functional status based on Clinical Dementia Rating (CDR) scale and neuropsychological battery are assessed. We defined mild cognitive impairment (MCI) based on either (1) CDR global score 0.5 (CDR-MCI) or (2) performance 1.5 SD below population means on any cognitive domain on neurocognitive battery (MCI-NC). Delirium was assessed daily post-operative day 2 through discharge using the confusion assessment method (CAM) and delirium index (DI). We investigate whether MCI – either definition – predicts delirium or delirium severity.Results:So far we have assessed 102 participants (mean age 65.1 ± 9; male: 75%) for PCD. Twenty six participants (25%) have MCI-CDR; 38 (62% of those completing neurocognitive testing) met MCI-NC criteria. Fourteen participants (14%) developed PCD. After adjusting for age, sex, comorbidity, and education, MCI-CDR, MMSE, and Lawton IADL score predicted PCD on logistic regression (OR: 5.6, 0.6, and 1.5, respectively); MCI-NC did not (OR [95% CI]: 11.8 [0.9, 151.4]). Using similarly adjusted linear regression, MCI-CDR, MCI-NC, CDR sum of boxes, MMSE, and Lawton IADL score predicted delirium severity (adjusted R2: 0.26, 0.13, 0.21, 0.18, and 0.32, respectively).Conclusions:MCI predicts post-operative delirium and delirium severity, but MCI definition alters these relationships. Cognitive and functional impairment independently predict post-operative delirium and delirium severity.

scholarly journals Acute Onset Ocular Hypotony after Coronary Artery Bypass Surgery

2017 ◽  
Vol 8 (1) ◽  
pp. 200-207
Author(s):  
Sarah Farukhi Ahmed ◽  
Audrey Xi Tai ◽  
Mason Schmutz ◽  
John Combs ◽  
Sameh Mosaed
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Vision Loss ◽  
Artery Bypass ◽  
Venous Pressure ◽  
Bypass Graft ◽  
Ischemic Optic Neuropathy ◽  
Cabg Surgery ◽  
Ocular Hypotony

Importance: The purpose of this case report is to evaluate risk factors associated with post-coronary artery bypass graft (CABG) ocular hypotony compared to post-CABG ischemic optic neuropathy. Observations: The patient described here is a single case at the University of California, Irvine Medical Center, from July 2016. This case demonstrates the rare incidence of acute post-CABG ocular hypotony and vision loss in a patient with prior history of optic atrophy. Both vision loss and hypotony resolved completely to baseline without intervention within 3 days postoperatively. Conclusions and Relevance: Severe anemia and large fluctuations in central venous pressure and blood pressure can occur in any patient undergoing CABG surgery. These hemodynamic shifts can cause transient ischemia to pressure controlling systems such as the ciliary body and reduce episcleral venous pressure. Other risk factors for acute hypotony in the setting of CABG surgery also include the use of hypertonic agents, cardiopulmonary bypass, and intravenous anesthesia.

scholarly journals Coronary Artery Bypass Graft Surgery in the Elderly

Circulation ◽  
2013 ◽  
Vol 128 (21) ◽  
pp. 2333-2343 ◽  
Author(s):  
Leonard Shan ◽  
Akshat Saxena ◽  
Ross McMahon ◽  
Andrew Newcomb
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
The Elderly ◽  
Artery Bypass Graft ◽  
Surgery In The Elderly

IMMUNE FUNCTION IN THE EARLY POSTOPERATIVE PERIOD PREDICTS OUTCOME IN CORONARY ARTERY BYPASS GRAFT (CABG) SURGERY

1990 ◽  
Vol 18 (Supplement) ◽  
pp. S252
Author(s):  
Marcus P. Haw ◽  
Gregory T. Steltzer ◽  
Emma J. Lewis ◽  
Bradley C. Borlase ◽  
Lynda Kabbash ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Immune Function ◽  
Coronary Artery Bypass ◽  
Postoperative Period ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Early Postoperative Period ◽  
Artery Bypass Graft ◽  
Cabg Surgery
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