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Coronary Artery Bypass Graft Surgery at the University Hospital of the West Indies, Jamaica: Analysis of Clinical Characteristics, Mortality and Length of Hospital Stay

DOI: 
10.7727/wimj.2016.549

ABSTRACT

Objectives: A detailed analysis of coronary artery bypass graft (CABG) surgical cases performed at the University Hospital of the West Indies (UHWI) has never been conducted. We present the demographic profile, clinical characteristics, and outcome of cases performed during the period March 2010 to March 2016.

Methods: Data from consecutive CABG surgeries performed during the study period were collected prospectively, entered into a computerized database and then analyzed. Outcome measures were 30-day operative mortality, ICU length of stay (ICU LOS) and total postoperative length of stay (PostOp LOS).                                                                                                     

Results: Of the 190 patients comprising the study population, 68.9% were males, and mean age (SD) was 61.3 (±10.2) years. The most frequent co-morbidities and risk factors were hypertension (82.1%) and diabetes (55.3%), cigarette smoking (33.7%) and hyperlipidaemia (89%). Left ventricular ejection fraction (LVEF) was found to be grades 1(good), 2(moderate), and 3(poor) in 50%, 44.2%, and 5.8% of patients, respectively. The majority (83%) were diagnosed with triple vessel disease. The crude, unadjusted 30-day mortality rate was 8.4%. Using the Canadian Risk Index Model, the mortality rates were: low risk (0-3), 5.5%; medium risk (4-7), 14.3%; and high risk (>8), 100%. The median ICU LOS and median postoperative LOS were 3 days (IQR, 2-4), and 8 days (IQR, 6-11), respectively. Logistic regression analysis revealed that grade 2 LVEF and urgent/emergent operations were predictors of mortality, female gender predictive of prolonged ICU LOS, and advanced age and female gender of borderline significance for prolonged PostOp LOS.                                             

Conclusion:This analysis of outcome of CABG cases performed at the UHWI provides an indication of current performance and serves as a benchmark against which future studies may be compared to determine the efficacy of future quality improvement initiatives.

Accepted: 
11 Jan, 2017
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e-Published: 03 Feb, 2017

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