接受冠状动脉旁路移植术的中国患者的危险因素与院内死亡率：对一个大型多中心中国数据库的分析

Department of Cardiovascular Surgery, Fuwai Hospital, Peking Union Medical College, Beijing, China

Objective: This study was undertaken to delineate outcomes and to assess risk factors for in-hospital mortality among Chinese patients undergoing coronary artery bypass grafting. Methods: From 2007 to 2008, a total of 9838 consecutive adult patients undergoing coronary artery bypass grafting were enrolled in the Chinese Coronary Artery Bypass Grafting Registry, which included 43 centers from 17 province-level regions in China. This registry collected information on 67 preoperative factors and 30 operative factors believed to influence in-hospital mortality. The relationship between risk factors and in-hospital mortality was evaluated by univariate and logistic regression analyses. Results: Overall in-hospital mortality was 2.5%. Eleven risk factors were found to be significant predictors for outcome: age (continuous), body mass index (continuous), left ventricular ejection fraction (continuous), preoperative New York Heart Association functional class III or IV, chronic renal failure, extracardiac arteriopathy, chronic obstructive pulmonary disease, preoperative atrial fibrillation or flutter (within 2 weeks), preoperative critical state, other than elective surgery, and combined valve procedure. Calibration with the Hosmer-Lemeshow test was satisfactory (P = .35), and the discrimination power was good (area under the receiver operating characteristic curve, 0.81; 95% confidence interval, 0.79-0.84). Conclusions: The risk profiles and in-hospital mortality of Chinese patients undergoing coronary artery bypass grafting were determined from data in the most up-to-date multi-institutional database. Eleven variables were demonstrated to be independent risk factors for in-hospital death after coronary artery bypass grafting. © 2012 by The American Association for Thoracic Surgery.

Hu, S.; 167A Beilishilu, Beijing 100037, China; email: shengshouhu@yahoo.com