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(Chest. 1996;110:1394-1398.)
© 1996 American College of Chest Physicians

Long-term Outcome When Major Complications Follow Coronary Artery Bypass Graft Surgery

Recovery After Complicated Coronary Artery Bypass Graft Surgery

Gary W. Wahl MD1; Andrew J. Swinburne MD1; Anthony J. Fedullo MD1; David K. P. Lee MD1; and Karen Bixby RN1

1 From the University of Rochester School of Medicine and Dentistry, Rochester (NY) General Hospital Pulmonary and Critical Care Unit

Objective: To determine whether information available 1 week after surgery correlates with long-term function in patients who suffer major complications after coronary artery bypass graft (CABG) surgery.

Design: An inception cohort study.

Setting: A 526-bed community teaching hospital.

Patients: All 67 patients who required at least 7 days of CT-ICU care following 2,751 consecutive CABG operations.

Main outcomes: Hospital survival, long-term survival, and functional ability at long-term follow-up.

Results: Forty-three patients survived hospitalization (64%), while 24 died 37±45 days (range, 7 to 190 days) after surgery. When 42 patients were surveyed 22±9 months after surgery, 21 of the survivors enjoyed excellent, independent function, 7 were moderately impaired but living at home, 6 were institutionalized with severe limitations, and 8 had died. Patients with very severe cardiac or neurologic dysfunction 1 week after surgery had an extremely poor outcome. When mechanical ventilation was required for causes other than primary failure of the respiratory system, long-term function and hospital survival were poor. Twelve of 14 patients with pulmonary complications survived hospitalization, and all 12 were alive at long-term follow-up.

Conclusion: More than half of patients requiring 7 days or more of ICU treatment after CABG surgery survive, and many enjoy excellent long-term function. However, those with very severe cardiac or neurologic dysfunction 1 week after surgery have little chance for independent recovery.

Key Words: CABG • complications • outcomes • survival

Submitted on March 18, 1996
Accepted on June 19, 2007




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