Original ArticlesIncreased Risk and Decreased Morbidity of Coronary Artery Bypass Grafting Between 1986 and 1994
Section snippets
The Cardiovascular Anesthesia Registry
The Cardiovascular Anesthesia Registry was established in 1982 to permit detailed analyses of patient characteristics and outcomes. The registry contains prospectively collected data on all adult patients who undergo cardiac operations at our institution.
The registry is maintained by one full-time database manager and statistician who supervises all data entry and extraction, one full-time database coordinator who is responsible for data entry and verification, and three data abstractors (two
Differences in Risk Scores
The distributions of risk scores differed significantly, with patients in group 2 being at significantly increased risk (p < 0.001 by χ2 analysis; Kendall’s tau = 0.102; 95% confidence interval = 0.082 to 0.122, indicating essentially no correlation between the distributions) (Fig. 1). Group 2 had significantly higher percentages of patients in 8 of the 13 risk factor categories, including higher percentages of patients with severe left ventricular dysfunction and emergency operations (Table 1
Comment
This retrospective analysis revealed that the patients admitted today to The Cleveland Clinic for cardiac operations are at greater preoperative risk than were the patients admitted 8 to 10 years ago. This increased risk is accompanied by a significant reduction in the overall morbidity rate (from 14.5% to 9%) and in the morbidity rate of traditionally high-risk subpopulations, such as patients who undergo emergency operations, those who undergo reoperations, and those who are of advanced age.
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