Studi osservazionali comorbilità nella rivascolarizzazione miocardica chirurgica: Fattori di rischio, controindicazioni

Translated title of the contribution: Comorbidity in surgical myocardial revascularization: Risk factors, contraindications

Tiziano Colombo, Stefano Pelenghi, Giuseppe Bruschi, Giuseppe Tarelli, Emanuela Montorsi, Mario Merli, Ettore Vitali

Research output: Contribution to journalArticle

Abstract

Background. The worsening evolution of patients undergoing surgical myocardial revascularization makes it difficult the stratification of the preoperative mortality risk, a correct evaluation of results and the comparison of results of different centers. The aim of the study was to evaluate the prognostic weight of comorbidity in surgical myocardial revascularization. Methods.We evaluated the characteristics of preoperative morbidity in 4999 patients who underwent surgical myocardial revascularization during four different periods (1979-1980, 1991-1992, 1994-1998, 1999-2002). We also evaluated the in-hospital results. Results. By comparing the four different periods, an increase in older age, female sex, comorbidity, three-vessel disease, and severe left ventricular dysfunction was observed. Surgical mortality decreased to 2.3%. Multivariate analysis of the 1999-2002 period showed that only renal insufficiency was a risk factor for in-hospital mortality. Conclusions. Although the preoperative risk is higher, nowadays hospital mortality is reduced thanks to new cardiac-surgical techniques and approaches that increasing the capacity of controlling comorbidity in the pre-, intra- and postoperative course. For a correct decision-making process it is crucial to assess how much comorbidity may influence the long-term follow-up in these patients independently of surgical myocardial revascularization.

Original languageItalian
Pages (from-to)376-381
Number of pages6
JournalItalian Heart Journal Supplement
Volume5
Issue number5
Publication statusPublished - 2004

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Myocardial Revascularization
Comorbidity
Hospital Mortality
Mortality
Left Ventricular Dysfunction
Renal Insufficiency
Decision Making
Multivariate Analysis
Morbidity
Weights and Measures

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Studi osservazionali comorbilità nella rivascolarizzazione miocardica chirurgica : Fattori di rischio, controindicazioni. / Colombo, Tiziano; Pelenghi, Stefano; Bruschi, Giuseppe; Tarelli, Giuseppe; Montorsi, Emanuela; Merli, Mario; Vitali, Ettore.

In: Italian Heart Journal Supplement, Vol. 5, No. 5, 2004, p. 376-381.

Research output: Contribution to journalArticle

Colombo, T, Pelenghi, S, Bruschi, G, Tarelli, G, Montorsi, E, Merli, M & Vitali, E 2004, 'Studi osservazionali comorbilità nella rivascolarizzazione miocardica chirurgica: Fattori di rischio, controindicazioni', Italian Heart Journal Supplement, vol. 5, no. 5, pp. 376-381.
Colombo, Tiziano ; Pelenghi, Stefano ; Bruschi, Giuseppe ; Tarelli, Giuseppe ; Montorsi, Emanuela ; Merli, Mario ; Vitali, Ettore. / Studi osservazionali comorbilità nella rivascolarizzazione miocardica chirurgica : Fattori di rischio, controindicazioni. In: Italian Heart Journal Supplement. 2004 ; Vol. 5, No. 5. pp. 376-381.
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abstract = "Background. The worsening evolution of patients undergoing surgical myocardial revascularization makes it difficult the stratification of the preoperative mortality risk, a correct evaluation of results and the comparison of results of different centers. The aim of the study was to evaluate the prognostic weight of comorbidity in surgical myocardial revascularization. Methods.We evaluated the characteristics of preoperative morbidity in 4999 patients who underwent surgical myocardial revascularization during four different periods (1979-1980, 1991-1992, 1994-1998, 1999-2002). We also evaluated the in-hospital results. Results. By comparing the four different periods, an increase in older age, female sex, comorbidity, three-vessel disease, and severe left ventricular dysfunction was observed. Surgical mortality decreased to 2.3{\%}. Multivariate analysis of the 1999-2002 period showed that only renal insufficiency was a risk factor for in-hospital mortality. Conclusions. Although the preoperative risk is higher, nowadays hospital mortality is reduced thanks to new cardiac-surgical techniques and approaches that increasing the capacity of controlling comorbidity in the pre-, intra- and postoperative course. For a correct decision-making process it is crucial to assess how much comorbidity may influence the long-term follow-up in these patients independently of surgical myocardial revascularization.",
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