Author + information
- Received July 27, 1987
- Revision received September 23, 1987
- Accepted October 9, 1987
- Published online March 1, 1988.
- Keith S. Naunheim, MD∗,
- Andrew C. Fiore, MD,
- John J. Wadley, BA,
- Lawrence R. McBride, MD,
- Kirk R. Kanter, MD,
- D.Glenn Pennington, MD, FACC,
- Hendrick B. Barner, MD, FACC,
- George C. Kaiser, MD, FACC and
- Vallee L. Willman, MD, FACC
- ↵∗Address for reprints: Keith S. Naurheiem, MD, Department of Surgery, St. Louis University Medical Center, 1325 South Grand Blvd., St. Louis, Missouri 63104.
The first 100 consecutive patients undergoing isolated coronary artery bypass surgery in 1975 were evaluated with respect to the incidence of operative risk factors and outcome. When compared with an identically selected group from 1985, there was significant worsening of the preoperative condition over the decade with regard to mean age (p < 0.0005), presence of congestive heart failure (p < 0.05), left ventricular dysfunction (p < 0.05), severity of coronary artery disease (p < 0.001) and incidence of emergency operation (p < 0.05). More patients in 1985 had associnted medical diseases such as diabetes (p < 0.01) and chronic lung disease (p < 0.005). There was an increase in the occurrence of vascular diseases (hypertension, renal dysfunction, peripheral vascular and cerebrovascular disease) (p < 0.05). Overall operative mortality increased from 1 to 8% (p < 0.05) over the decade.
Despite the deterioration in the clinical profile of the patient undergoing coronary bypass surgery, elective procedures were still performed with low mortality. The significant increase in overall mortality was chiefly in patients undergoing emergency operation (p < 0.05). There were also increases in operative morbidity including low output syndrome (p < 0.01) and respiratory (p < 0.005) and neurologic (p = 0.06) complications.
☆ This study was presented at the 36th Annual Scientific Session of the American College of Cardiology. New Orleans, Louisiana, March 1987.
- Received July 27, 1987.
- Revision received September 23, 1987.
- Accepted October 9, 1987.