Abstract P224: Completeness of Revascularization Predicts Long-Term Survival Benefit in CABG Surgery
Notice bibliographique
Résumé
Objectives: The primary objective of this study was to examine the effect of complete vs. incomplete revascularization in CABG surgery on long-term mortality. The secondary objective of this study was to examine the effect of variable grafting strategies on long-term mortality. Methods: All consecutive CABG surgeries performed at a single tertiary care center between 1995-2007 were reviewed. Long-term survival rates were compared among patients based on completeness of revascularization, the use of no arterial graft (all saphenous vein), single arterial graft, and multiple arterial grafts. Groups were also stratified based on the type of arterial grafts used (bilateral internal mammary arteries (BIMA) vs. multiple arterial grafts with only one IMA). Cox proportional Hazards ratio models were generated to adjust for differences in clinical presentation between the CABG groups. Results: A total of 8977 isolated CABG operations were preformed at our institution during that period. These patients were followed for a median time of 3.5 years (IQR=1.1-6.4). In this patient population, incomplete revascularization predicted an increased risk of mortality (HR=1.25; CI=1.12-1.39). A single arterial graft was performed in the majority of patients (63%; n=5637) with 28% of patients (n=2532) receiving multiple arterial grafts. Patients who received multiple arterial grafts were more likely to be younger, male, and undergo non-urgent surgery. After adjusting for these differences, patients who received an arterial graft (LIMA, RIMA, or radial) were shown to have improved survival when compared to patients who did not (HR=0.74; CI=0.65-0.83). Among patients who received multiple arterial grafts, percent survival for patients with BIMA grafts at 10 years was 70.4% compared to 66.1% for patients with single arterial grafts. Furthermore, patients who received BIMA grafts had the lowest predicted mortality among arterial graft patients when compared to patients who did not receive an arterial graft (HR=0.63; CI=0.51-0.77). Conclusions: We were able to show that after adjusting for differences in clinical presentation, both completeness of revascularization and BIMA grafting are strong independent predictors of long-term survival among CABG patients.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».