关键词: 冠脉动脉搭桥术；老年；死亡率；远期

Abstract:

Objective   To invesgate the independent factors influencing the long-term mortality of elderly patients(age more than 70 years old) undergoing coronary artery bypass grajb surgery. Methods   Preoperative,intraoperative and postoperative datas of 345 elderly patients(age more than 70 years old), who underwent coronary artery bypass graft surgery from December of 2005 to May of 2011, were reviewed. They were divided into 2 groups according to the followup results(i.e. dead or not).   45 patients died during the follow-up. Comparing the  datas of the 2 groups,the factors, of which P value was less than 0.05, were included into the Cox multivariate analysis to extract the independent factors influencing the long-term mortality. Results   Among all 345 patientst, there were 74 on-pump coronary artery bypass graft, 219 off-pump coronary artery bypass graft, and 52 cardiopulmonary bypass assistant beating heart coronary artery bypass graft. 15 patients died in the hospital after the surgery(4.35%). For the other 345 patietns, the follow-up period was 72 months(1-72 months, median 68 months, mean 62.557±1.282 months). The accumulated mortality during the follow-up was 13.04% (45/345).5 independent factors influencing the long-term mortality, including intubation time (RR: 1.002；95%CI 1.001-1.003), postoperative renal dysfunction (RR 20.59; 95%CI 6.131-69.154), preoperative CVD (RR 4.605；95%CI 1.796-11.806), regularly intaking statins (RR 0.334; 95%CI 0.158-0.706), and good blood pressure control (RR 0.135; 95%CI 0.047-0.385). Conclusion   The inbubation time, postoperative renal dysfunction, preoperative CVD, regularly intaking statins and good blood pressure control are the independent factors influencing the long-term mortality of elderly patients(age more than 70 years old) undergoing coronary artery bypass graft surgehy.

Key words: Coronary artery bypass graft; Elderly; Mortality; Long-term