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(Chest. 1999;116:1570-1574.)
© 1999 American College of Chest Physicians

Factors Associated With Health Indicators in Patients Undergoing Coronary Artery Bypass Surgery*

Yasmin Maor, , MD; Yael Cohen, MD; Liraz Olmer, MsC; Benjamin Mozes, MD and for the Israeli Coronary Artery Bypass (ISCAB) Study Consortium{dagger}

* From the 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. {dagger} A complete list of participants is listed in the Appendix.

Correspondence to: Yasmin Maor, MD, The Center for the Study of Clinical Reasoning, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer 52621, Israel; e-mail: maory{at}post.tau.ac.il

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.

Key Words: coronary artery bypass graft surgery • health indicators • outcome • risk






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