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Influence of concomitant CABG and urgent/emergent status on mitral valve replacement surgery
Influence of concomitant CABG and urgent/emergent status on mitral valve replacement surgery
- Source :
- The Annals of Thoracic Surgery. 70:778-783
- Publication Year :
- 2000
- Publisher :
- Elsevier BV, 2000.
-
Abstract
- Background . Outcomes and resource utilization of patients undergoing mitral valve replacement (MVR) with or without concomitant coronary artery bypass grafting (CABG) were reviewed. Methods . Data for 1,844 patients undergoing isolated primary MVR at Emory University Hospitals between 1980 and 1997 were recorded prospectively in a computerized database. Results . The four groups included patients undergoing elective MVR with (n = 360) or without CABG (n = 1332) and urgent/emergent MVR with (n = 66) or without CABG (n = 86). Length of stay was significantly higher in patients undergoing elective MVR with CABG (15 days) than in those without CABG (11 days) but was not significantly different in patients undergoing urgent/emergent MVR with CABG (17 days) than in those without CABG (19 days). In-hospital mortality was significantly higher for patients undergoing elective (14%) or urgent/emergent (41%) MVR with CABG than in those undergoing MVR without CABG (elective:6%; urgent/emergent:20%). The 19-year survival rate was 32% for patients undergoing elective MVR with CABG compared with 51% for those without CABG and 28% for patients undergoing urgent/emergent MVR with CABG compared with 46% for those without CABG. Multivariate correlates of long-term mortality included older age, concomitant CABG, and urgent/emergent status. Hospital costs were significantly higher for patients undergoing elective MVR with ($33,216) than for those without ($23,890) CABG. No significant difference in cost were noted between patients undergoing urgent/emergent MVR with ($40,535) and without ($31,981) CABG. Conclusions . The addition of CABG or urgent/emergent status to patients undergoing MVR significantly increases morbidity, mortality, and costs. Careful scrutiny of the benefits versus resource utilization is required for patients undergoing high risk MVR.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Bypass grafting
medicine.medical_treatment
Humans
Medicine
In patient
cardiovascular diseases
Coronary Artery Bypass
Survival rate
Heart Valve Prosthesis Implantation
business.industry
Significant difference
Mitral valve replacement
Length of Stay
Middle Aged
University hospital
Surgery
Survival Rate
surgical procedures, operative
Elective Surgical Procedures
Concomitant
Multivariate Analysis
Costs and Cost Analysis
Mitral Valve
Mitral valve replacement surgery
Female
Emergencies
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 70
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....f137df26761bdec28239fa585194252d
- Full Text :
- https://doi.org/10.1016/s0003-4975(00)01641-6