Success Rate of Coronary Artery Bypass Grafting on Elderly Patients in Dr. Soetomo General Academic Hospital, Surabaya

Abstract

Highlights: CABG is the most performed cardiac surgery in Indonesia, and most patients undergoing this surgery are above 60 years old. CABG success rate is not significantly influenced solely by the patient’s age but also by several perioperative characteristics such as gender, comorbidities, and other variables included in the calculation of EuroSCORE II. Abstract Introduction: Coronary artery disease (CAD) causes more than a quarter of deaths in Indonesia and is found to be more prevalent in the elderly (≥60 years old). Treatment includes coronary artery bypass grafting (CABG), the most-performed cardiac surgery in Indonesia. This study aimed to determine the short-term and one-year postoperative success, morbidity, and mortality rates with their causes in Dr. Soetomo General Academic Hospital, Surabaya. Methods: This was a cross-sectional retrospective study using secondary data obtained from 85 medical records of CABG patients aged ≥60 years old in the Department of Thoracic, Cardiac, and Vascular Surgery, Dr. Soetomo General Academic Hospital, Surabaya, from January 2018 to December 2020. Aside from descriptive statistics, logistic regression was conducted to assess the relationship between EuroSCORE II and the success of CABG in elderly patients. Results: Patients were mostly male in their sixties with a mean of 65.5 ± 4.9 years old, had three-vessel disease, and had a predicted mortality rate of 1.6%. The average number of grafts used was 3.3 ± 0.7, and the average length of hospital stay was 7.4 ± 2.4 days. The morbidity rate was 71.8%, with bleeding as the most common complication, a 17.6% mortality rate with septic shock as the most frequent cause, and a success rate of 82.4% (short-term) and 80% (one-year postoperative). Higher EuroSCORE II was found to significantly decrease the probability of both short-term and one-year postoperative success. Conclusion: The success rates of CABG in Dr. Soetomo General Academic Hospital, Surabaya, were 82.4% (short-term) and 80% (one-year postoperative), negatively correlated with EuroSCORE II.