Coronary Artery Bypass Surgery Clinical Analysis Of Risk Factors Of Death

Objective:To analyze and probe the high risky factors of coronary artery bypass grafting(CABG).Methods:The research data is clinical material of 437 patients who had been performed CABG operation in the cardiovascular surgery department of the affiliated hospital of Qingdao university medical school from January 2003 to May 2008.We chosed 38 risk factors according to the features of this group patients.First of all,the logistic regression univariate analyses were performed to evaluate the risk factors and then the stepwise logisitic regression analyses were performed to evaluate those significant risk factors. The aim is to screen the high risky factors for mortality.Results:The results show that 23 risk factors were statistical significance in the logistic regression univariate analyses.they included 13 preoperative selected risk factors,2 intraoperative selected risk factors,8 postoperative selected risk factors.There were 4 risk factors which were statistical significance in 23 risk factors stepwise logistic regression analyses and respiratory infections,postoperative cardiac ventricular arrhythmias,cardiac function(NYHA) grade 3-4,perioperative myocardic infarction were lined up according to the odds rations(OR) respectively.The stepwise logistic regression analyses show that there were 6 risk factors which were statistical significance in 16 preoperative and intraoperative risk factors.According to the OR respectively,they were ranked as follow:CABG performed less than 3 weeks after AMI,valvular surgery operation, mitral regurgitation and,left main coronary artery stenosis＞50%,the age of 70,aortic regurgitation.The results of stepwise logistic regression analyses is that 7 risk factors were statistical significance in 13 preoperative and risk factors.According to the OR respectively,they were ranked as follow:CABG performed less than 3 weeks after AMI, mitral regurgitation and aortic regurgitation,mitral stenosis,the age of 70,ejection fraction(EF)＜50%,left main coronary artery stenosis＞50%.Conclusion:CABG performed less than 3 weeks after AMI,mitral regurgitation and aortic regurgitation,mitral stenosis,the age of 70,ejection fraction(EF)＜50%,left main coronary artery stenosis＞50%were independent risk factors for mortality in preoperative selected risk factors,valvular surgery operation,mitral regurgitation was independent risk factor for mortality in intraoperative selected risk factors.Respiratory infections,postoperative cardiac ventricular arrhythmias and perioperative myocardic infarction were independent risky factors for mortality in postoperative selected risky factors.These factors have important clinical significance.we should pay attention to these factor.