Evolución en una década del riesgo quirúrgico en cirugía coronaria según el predictor EuroSCORE logísticoestudio monocéntrico

Abstract

Introduction. Risk profile change of patients undergoing coronary artery bypass grafting (CABG) in recent years is supported by numerous studies. Studying the evolution of the risk profile and its conditioning factors on the Canary Islands is transcendental. Objectives. To compare the mortality predicted by Logistic EuroSCORE in patients undergoing CABG in 2003 and 2012 (primary objective), and also its risk factors (secondary objective). Methods. 260 patients who underwent CABG in the Cardiovascular Surgery Department of the University Hospital of the Canary Islands were selected (173 patients in 2003 - 87 patients in 2012), including those who underwent other major cardiac procedures than isolated CABG. Risk factors were obtained from the discharge summary contained in SAP, and were collected in Microsoft Office Excel 2007. The surgical theoretical risk of each patient in accordance with the logistic EuroSCORE was calculated. Statistical software package SPSS® v.18.0 was used to analyze the predicted mortality and its risk factors. Results. The mortality predicted by EuroSCORE has not changed (p=0.243). The medians were 5.865 in 2003 and 5.330 in 2012. Risk factors have not changed either, except: creatinine (p<0.001), whose median was 0.9 mg/dl in 2003 and 0.8 mg/dl in 2012; unstable angina (p<0.001), 41% in 2003 and 17.2% in 2012; myocardial infarction (p<0.05), 22% in 2003 and 6.9% in 2012; other major surgery than isolated CABG (p<0.001), 12.1% in 2003 and 31% in 2012; and surgery on thoracic aorta (p<0.05), 0% in 2003 and 2.3% in 2012. Conclusion. The mortality predicted by Logistic EuroSCORE in coronary surgery has not changed. Most of the risk factors, such as age, female sex, chronic pulmonary disease, extracardiac arteriopathy, neurological dysfunction or previous cardiac surgery, have not change either. Some risk factors have changed: creatinine values and prevalence of unstable angina and myocardial infarction decreased; and other major cardiac procedures than isolated CABG increased, including surgery on thoracic aorta.