Influence of ejection fraction on hospital mortality, morbidity, and costs for CABG patients. Discussion.
Society of Thoracic Surgeons. Annual meeting. New Orleans LA USA, 1994/01/31.
Preoperative ejection fraction (EF) has been shown to adversely affect postoperative hospital mortality and morbidity for patients undergoing isolated coronary artery bypass grafting.
To investigate influence of EF on isolated coronary artery bypass grafting outcomes (overall hospital mortality, hospital cardiac mortality, hospital morbidity, and hospital costs), data were reviewed from 1,354 consecutive patients who underwent isolated coronary artery bypass grafting between January 1,1990, and April 30,1992, at a single nonprofit hospital.
Overall hospital mortality was 4.06% (cardiac, 2.36%). Hospital morbidity was 14.25% (including mortality).
Hospital costs (not charges) averaged $16,673 per patient.
To explore the impact of preoperative EF, EF was stratified into regular intervals.
Each interval was then compared with regard to hospital mortality, morbidity, and average costs.
A new statistical tool, discharge analysis, was developed to analyze the cost data.
This was necessary because previous efforts at cost analysis have used tools inappropriate for real world cost data.
The statistical analysis showed that patients with EF of 0.40 or greater had the best outcomes (lowest mortality, morbidity, and cost).
Once the EF is 0.40 or greater the EF does not carry further predictive value.
At EF less than 0.40, patients with EF less than 0.30 have a poorer outcome than patients with EF of 0.30 to 0.39.
Mots-clés Pascal : Cardiopathie coronaire, Dérivation, Aortocoronaire, Fraction éjection, Fonction ventriculaire gauche, Préopératoire, Hospitalisation, Economie santé, Evaluation, Exploration, Traitement, Pronostic, Mortalité, Homme, Complication, Appareil circulatoire pathologie, Chirurgie, Hémodynamique
Mots-clés Pascal anglais : Coronary heart disease, Bypass, Aortocoronary, Ejection fraction, Left ventricle performance, Preoperative, Hospitalization, Health economy, Evaluation, Exploration, Treatment, Prognosis, Mortality, Human, Complication, Cardiovascular disease, Surgery, Hemodynamics
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0103384
Code Inist : 002B25E. Création : 199608.