Outcomes after coronary artery bypass grafting in patients with myocardial infarction, cardiogenic shock and unresponsive neurological state: analysis of the Society of Thoracic Surgeons Database

Previous studies have demonstrated a 20% mortality rate among patients undergoing isolated coronary artery bypass grafting (CABG) for cardiogenic shock. However, outcomes following CABG for cardiogenic shock in patients who are neurologically unresponsive preoperatively are unknown. Utilizing the So...

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Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2018-10, Vol.54 (4), p.710-716
Main Authors: Cox, Morgan L, Gulack, Brian C, Thibault, Dylan P, He, Xia, Williams, Matthew L, Thourani, Vinod H, Jacobs, Jeffery P, Brennan, J Matthew, Daneshmand, Mani A, Acharya, Deepak
Format: Article
Language:English
Subjects:
Aged
Coronary Artery Bypass - methods
Databases, Factual
Female
Follow-Up Studies
Hospital Mortality - trends
Humans
Male
Middle Aged
Myocardial Infarction - complications
Myocardial Infarction - mortality
Myocardial Infarction - surgery
Registries
Retrospective Studies
Risk Factors
Shock, Cardiogenic - etiology
Shock, Cardiogenic - surgery
Societies, Medical
Survival Rate - trends
Thoracic Surgery
Treatment Outcome
United States - epidemiology
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Summary:Previous studies have demonstrated a 20% mortality rate among patients undergoing isolated coronary artery bypass grafting (CABG) for cardiogenic shock. However, outcomes following CABG for cardiogenic shock in patients who are neurologically unresponsive preoperatively are unknown. Utilizing the Society of Thoracic Surgeons Adult Cardiac Surgery Database between July 2011 and December 2013, patients undergoing urgent or emergent CABG within 7 days of an acute myocardial infarction complicated by cardiogenic shock were identified. Patients were stratified on the basis of whether they had a non-medically induced unresponsive state within 24 h of surgery. Of the 5259 patients with acute myocardial infarction complicated by cardiogenic shock who underwent CABG during the study period, 243 (4.62%) patients had an unresponsive preoperative neurological state. The unresponsive cohort had a higher 30-day operative mortality than the responsive cohort (33.74% vs 16.91%, P 
ISSN:1010-7940
1873-734X
DOI:10.1093/ejcts/ezy114