关键词: 非体外循环冠状动脉旁路血管移植术, 术后病死率, 危险因素

Abstract:

Objective To determine the risk factors of perioperative mortality in patients undergoing off-pump coronary artery bypass grafting surgery(OPCABG).
Methods The perioperative data of 2 379 patients undergoing OPCABG were investigated based on the selfmade perioperative OPCABG database. The specific risk factors were identified by univariate analysis and multiple logistic regressions.
Results Totally 32 patients died perioperatively, the average mortality rate was 1.3%(male: 19/1 830; female: 13/549). Univariate analysis demonstrated that perioperative continuous renal replacement therapy; preoperative ejection fraction less than 40%, intraoperative ventricular fibrillation, emergent OPCABG, intraoperative intra-aortic balloon pump, gender, previous myocardial infarction, and age were risk factors contributing to postoperative mortality. Multivariate analysis demonstrated that postoperative continuous renal replacement therapy, preoperative ejection fraction less than 40%, emergent case and gender were the independent predictors of perioperative mortality in patients undergoing OPCABG.
Conclusion Perioperative continuous renal replacement therapy, preoperative ejection fraction less than 40%, emergent case and gender were the independent predictors of postoperative mortality in patients undergoing OPCABG. An intensive perioperative renal protection, adequate cardiac functional support, improving the quality of perioperative management to emergent and women patients are important aspects for the outcome improving to patients undergoing OPCABG surgery.

Key words: off-pump coronary artery bypass grafting, postoperative mortality, risk factors