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Risk factors and in-hospital mortality in Chinese patients undergoing coronary artery bypass grafting: Analysis of a large multi-institutional Chinese database

机译:中国冠状动脉搭桥术患者的危险因素和院内死亡率:大型多机构中国数据库的分析

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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.
机译:目的:本研究旨在描述中国冠状动脉搭桥术患者的结局并评估其院内死亡率的危险因素。方法:从2007年到2008年,中国冠状动脉旁路移植术登记处共纳入了9838名连续的成人冠状动脉旁路移植术患者,其中包括来自中国17个省级地区的43个中心。该注册表收集了有关67种术前因素和30种手术因素的信息,这些因素被认为会影响住院死亡率。通过单因素和逻辑回归分析评估危险因素与住院死亡率之间的关系。结果:总体住院死亡率为2.5%。发现有11个危险因素是结果的重要预测指标:年龄(连续),体重指数(连续),左心室射血分数(连续),术前纽约心脏协会功能性III或IV级,慢性肾功能衰竭,心外膜动脉病,慢性阻塞性肺疾病,术前房颤或扑动(2周内),术前危重状态(选择性手术除外)和联合瓣膜手术。用Hosmer-Lemeshow测试进行校准的结果令人满意(P = 0.35),分辨力也很好(接收器工作特性曲线下的面积为0.81; 95%置信区间为0.79-0.84)。结论:根据最新的多机构数据库中的数据确定了接受冠状动脉搭桥术的中国患者的风险概况和院内死亡率。事实证明,有11个变量是冠状动脉旁路移植术后院内死亡的独立危险因素。

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