In-Hospital and Long-Term Mortality in 35,173 Chinese Patients Undergoing Coronary Artery Bypass Grafting in Beijing: Impact of Sex, Age, Myocardial Infarction, and Cardiopulmonary Bypass

Abstract

Objective The purpose of this study was to investigate the independent risk factors for mortality, the correlation between female sex and mortality, and the effects of cardiopulmonary bypass on prognosis in Chinese patients undergoing coronary artery bypass grafting (CABG). Setting A retrospective, observational study. Participants The study included 26,926 (76.6%) men and 8,247 (23.4%) women. Interventions Patients undergoing isolated CABG were included in this study. Measurements and Main Results The medical records of patients undergoing CABG between January 1, 2006, and December 31, 2011, in Beijing were reviewed. Multivariate logistic regression and propensity score-matched analyses were performed to analyze the independent risk factors for in-hospital and long-term mortality. A total of 35,173 patients (76.6% men) were included in this study. Women were significantly older than men, and the proportions of women presenting with hypertension and unstable angina at hospital admission were significantly higher than those of men (all p<0.05). Women showed significantly higher in-hospital mortality (1.62% v 1.30%, p = 0.0248) and long-term mortality (3-year mortality, 10.2% v 7.3%, p<0.0001) than did men. Multivariate logistic regression analyses on the total patients and the propensity score-matched group revealed that female sex was not an independent risk factor for in-hospital mortality, whereas age and off-pump CABG were associated significantly with mortality (all p<0.0001). Age, a history of myocardial infarction before CABG, and on-pump CABG were independent risk factors for long-term mortality (all p<0.0001), but female sex was not. Conclusions These findings suggested that advancing age but not female sex, appeared to be an independent risk factor for post-CABG in-hospital and long-term mortality, and off-pump CABG may be associated with worse in-hospital mortality and better long-term survival compared with on-pump CABG.