Y Maor1, Y Cohen, L Olmer, B Mozes. 1. Center for the Study of Clinical Reasoning, The Gertner Institute for Epidemiology and Health Policy Research, Sackler School of Medicine, Tel Aviv University, Sheba Medical Center, Tel Hashomer, Israel. maory@post.tau.ac.il
Abstract
BACKGROUND: The main goals of coronary artery bypass graft (CABG) surgery for most patients are to relieve angina, to improve functional capacity, to return to work, and to improve health. A limited amount of information is available regarding the various attributes that are associated with achieving these goals. STUDY OBJECTIVES: To investigate different patient attributes affecting these outcomes. DESIGN: Prospective data collection. SETTING: Fourteen medical centers that perform CABG surgery in Israel. PATIENTS: The 4,012 patients who underwent CABG surgery during 1994. MEASUREMENTS: Trained nurses collected data using structured questionnaires prior to and 4 to 5 months after the operation. Using logistic regression, four risk models were created to the following health indicators: recurrence of angina, functional capacity, return to work, and perception of health. Candidate variables were sociodemographic details, major comorbidities, risk factors for cardiac disease, and severity of cardiac disease. RESULTS: The mean age of the patients was 63.8 years old, 79.3% were men, 59.9% were elective operations, and left main disease was found in 17.3%. Multivariate logistic regression revealed that the variables that significantly contributed to three or more of the models were Sephardic Jewish origin, female gender, left ventricular dysfunction, and diabetes mellitus. CONCLUSIONS: There is a similarity between risk factors of various health indicators in CABG surgery patients. Thus, it is possible to define a population at high risk that may not benefit from the procedure.
BACKGROUND: The main goals of coronary artery bypass graft (CABG) surgery for most patients are to relieve angina, to improve functional capacity, to return to work, and to improve health. A limited amount of information is available regarding the various attributes that are associated with achieving these goals. STUDY OBJECTIVES: To investigate different patient attributes affecting these outcomes. DESIGN: Prospective data collection. SETTING: Fourteen medical centers that perform CABG surgery in Israel. PATIENTS: The 4,012 patients who underwent CABG surgery during 1994. MEASUREMENTS: Trained nurses collected data using structured questionnaires prior to and 4 to 5 months after the operation. Using logistic regression, four risk models were created to the following health indicators: recurrence of angina, functional capacity, return to work, and perception of health. Candidate variables were sociodemographic details, major comorbidities, risk factors for cardiac disease, and severity of cardiac disease. RESULTS: The mean age of the patients was 63.8 years old, 79.3% were men, 59.9% were elective operations, and left main disease was found in 17.3%. Multivariate logistic regression revealed that the variables that significantly contributed to three or more of the models were Sephardic Jewish origin, female gender, left ventricular dysfunction, and diabetes mellitus. CONCLUSIONS: There is a similarity between risk factors of various health indicators in CABG surgery patients. Thus, it is possible to define a population at high risk that may not benefit from the procedure.
Authors: William E Lawson; John C K Hui; Elizabeth D Kennard; Sheryl F Kelsey; Andrew D Michaels; Ozlem Soran Journal: Clin Cardiol Date: 2006-02 Impact factor: 2.882