The Risk Stratification and Early Post-Operative Outcomes in Elderly Patients Undergoing CABG: A Comparative Cohort Study Risk Stratification and Early Outcomes in Elderly CABG Patients
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Abstract
Objective:To evaluate the association between aortic cross-clamp duration and early post-operative outcomes in patients undergoing coronary artery bypass grafting (CABG).
Methodology: This cross-sectional study was conducted in Department of Cardiac Surgery Punjab Institute of Cardiology, Lahore, Pakistan, over a period of 6 months after obtaining ethical approval from the Institutional Review Board. A total of 190 patients aged 50–75 years who were admitted for elective CABG were included and classified into two cohorts according to aortic cross-clamp duration: low-risk (<75 minutes) and high-risk (≥75 minutes). Baseline demographic and clinical characteristics were measured. Patients were followed during the same hospital admission for early post-operative outcomes, including intensive care unit (ICU) stay, hospital stay, stroke and in-hospital mortality. Continuous variables were compared using the independent-samples t-test, while Fisher's exact test was used for categorical outcomes. A p-value ≤0.05 was considered statistically significant.
Results: Baseline demographic and clinical characteristics showed no statistically significant differences between the two groups. ICU stay and hospital stay were also comparable between groups. However, stroke occurred more frequently in the high-risk cohort than in the low-risk cohort (7.4% vs. 1.1%; p=0.030). In-hospital mortality was not significantly different between the high-risk and low-risk cohorts (8.4% vs. 5.3%; p=0.572).
Conclusion: Longer aortic cross-clamp duration was associated with a higher frequency of stroke among patients undergoing CABG, while early mortality, ICU stay and hospital stay remained comparable between the two cohorts. Careful perioperative monitoring and appropriate management of cross-clamp duration may help improve early post-operative outcomes.
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