Long-term outcome after coronary artery bypass grafting in XXXX or cardiopulmonary resuscitation.

@entity1 @entity64 @entity66 @entity6 @entity1188 @entity1455
OBJECTIVES: Coronary artery bypass grafting carried out in @entity1 in @entity1455 or receiving cardiopulmonary resuscitation is an infrequently performed procedure, disrupting the normal process with a dramatic early risk. These circumstances mandate an analysis of the benefit, including the early identification of the late survivors. METHODS: A consecutive series of @entity1 undergoing coronary artery bypass grafting while in @entity1455 (n = 167) or while receiving cardiopulmonary resuscitation (n = 92) from August 1979 until August 2001 were studied by using time-related and multivariate methodologies and a common-closing-date follow-up methodology. The events leading to the preoperative condition were either a recent catheterization, recent coronary artery bypass grafting, recent percutaneous transluminal coronary angioplasty, an @entity1188 at home, an @entity1188 in the hospital, or an @entity1188 after a recent @entity1188 . RESULTS: The 1- and 10-year survival was 59% +/- 6% and 47% +/- 7%, respectively. A normal hazard of late death was observed beyond the protracted early hazard. Multivariate analysis of survival identified an increased risk in the presence of additional comorbidity, treated @entity6 , a lower pH at entry into the operating theater, and the presence of @entity66 . The discriminatory power for hospital mortality of the predictive variables was low (receiving operator characteristic range, 0.56-0.69). The 30-day freedom from hospital discharge alive was 33% +/- 7%. The 8-day freedom from @entity64 was 94% +/- 3%, and 8-day freedom from mechanical univentricular or biventricular support was 87% +/- 5%. The 10-year freedom from cardiosurgical reintervention was 90% +/- 6%. CONCLUSIONS: Coronary artery bypass grafting in @entity1455 or during cardiopulmonary resuscitation has an extremely high and protracted periprocedural risk but is balanced by a satisfactory late survival. An early prediction of the hospital survivors is difficult.
