Aortocoronaire bypasschirurgie: voor oordeel over postoperatief beloop follow-up nodig gedurende tenminste een halfjaar

To determine how the mortality and morbidity after aortocoronary bypass surgery during the hospital stay correspond with those in the first 6 months after the operation.

Design

Prospective and retrospective.

Method

Data of 563 patients undergoing isolated myocardial revascularization in 1998 in the Academic Hospital Nijmegen, the Netherlands, were collected on mortality and morbidity 180 days after the operation. The Parsonnet score was used to assess the operative risk of the patients.

Results

The patient group consisted of 422 males and 141 females, with a mean age of 64.3 years. The median Parsonnet score was 6 (range: 0-50). The mean hospital stay was 7.9 days (SD: 9.4). The hospital mortality was 3.9 (22/563). The follow-up was 100. During the follow-up 11 patients died, 10 from cardiac causes. Six months postoperatively the mortality was 5.9 (22/563).The Kaplan-Meier curve of the survival probability rate showed a persistent decrease, mainly in the higher risk patients. Non-fatal cardiovascular events were registered in 9.6 of the surviving patients (51/530).

Conclusion

The hospital mortality and morbidity after aortocoronary bypass surgery were considerably lower than the total postoperative mortality and morbidity during the first 6 months after the operation. For assessment of the postoperative course, systematic follow-up over 6 months is necessary.