评价SYNTAX评分对CABG患者术后院内死亡的影响

To evaluate the effect of SYNTAX score on in-hospital mortality of CABG patients

目的评价冠状动脉解剖学评分—SYNTAX评分对冠状动脉旁路移植术(CABG)患者院内死亡的影响。方法收集2017年7月至2018年12月期间天津市胸科医院心血管外科收治的1301例单纯行CABG手术患者临床资料,其中男946例,女355例;年龄26~84岁,平均(63.0±8.3)岁。以术后院内全因死亡或自动出院为临床终点,分为生存组(1281例)和死亡组(20例,包括死亡10例和自动出院10例)。对两组患者临床资料行单因素和多因素logistic回归分析,得出影响CABG术后院内死亡的危险因素,评价SYNTAX评分对CABG患者术后院内死亡的影响。结果单因素logistic分析结果示,年龄、危急状态、术前最近1次肌酐水平、术前最近1次血白蛋白水平、术前最近1次N末端B型利钠肽原水平、NYHA心功能分级、乳内动脉使用、SYNTAX评分与术后院内死亡存在相关性。多因素logistic分析结果示,年龄≥75岁、糖尿病史、危急状态、肌酐清除率<85 ml/min、白蛋白<35 g/L、NYHA心功能Ⅲ~Ⅳ级、SYNTAX≥29分为CABG术后院内死亡的独立危险因素。结论SYNTAX≥29分为影响本院CABG患者院内死亡的独立危险因素。

Objective To evaluate the effect of coronary artery anatomical score(SYNTAX score)on in-hospital mortality of CABG patients.Methods The clinical data of patients who were performed with a CABG surgery alone in the Department of Cardiovascular Surgery,Tianjin Chest Hospital from July 2017 to December 2018 were collected.The clinical end point was all-cause in-hospital death or against-advice discharge after surgery.Univariate analysis and multivariate logistic regression analysis were performed on the clinical data of the patients to obtain the risk factors affecting the in-hospital death of CABG in our center,to evaluate the influence of SYNTAX score on the in-hospital death of CABG.Results Univariate logistic analysis showed that age,critical condition,creatinine level,serum albumin level,NT-proBNP level,NYHA grade,internal mammary artery use,SYNTAX score were correlated with in-hospital mortality.Multivariate analysis showed that age(≥75 years old),history of diabetes mellitus,critical state,creatinine clearance rate<85 ml/min,albumin<35 g/L,NYHAⅢ-Ⅳ,SYNTAX score(≥29)were independent risk factors for in-hospital mortality after CABG.Conclusion Coronary artery anatomy score-SYNTAX score(≥29)was an independent risk factor for in-hospital mortality in CABG patients in our hospital.