Abstract：
BACKGROUND: Several factors intervene in the evolution of the characteristics of Coronary artery bypass grafting (CABG), such as demographic changes, surgical technique, and perioperative care. Our objective was to analyze the evolution of the characteristics of coronary artery disease in patients treated with CABG and its immediate results.
METHODS: In an analytical study, we analyzed a cohort of patients with isolated CABG from January 2006 to December 2008 and from January 2016 to December 2018 in Hospital Clínico Regional Concepción, Chile. After the ethics committee\'s approval, we reviewed the database and surgical protocols. We used Chi-square and U Mann Whitney tests for statistical analysis (SPSSv25®), considering significant p < 0,05.
RESULTS: We analyzed 1,400 isolated CABG, 658 from the first period and 742 from the second, with a mean age of 62.0 ± 8.7 and 64.6 ± 9.3 respectively (p < 0.001). The subgroup with ventricular dysfunction in the second period showed a significant increase in diabetes mellitus, chronic obstructive pulmonary disease, acute myocardial infarction (AMI), and severe ventricular dysfunction. The second group decreased off-pump surgery and increased the use of ≥ 2 arterial grafts (p < 0.05). The Additive EuroSCORE I increased from 3.6 ± 2.5 to 4.4 ± 2.7 (p = 0.001). High-risk subgroup: 137 (20.8%) to 236 (31.8%), p < 0.001. Mortality of 13 (1.98%) and 16 (2.2%) in the first and second group respectively, p = 0.813.
CONCLUSIONS: There was a significant increase in the estimated surgical risk; however, mortality remained unchanged. The increase in surgical risk is consistent with the increase in mean age and prevalence of comorbidities, as well as the increase in severe ventricular dysfunction in the group ofpatients with ventricular dysfunction and recent AMI in the second period.
METHODS: In an analytical study, we analyzed a cohort of patients with isolated CABG from January 2006 to December 2008 and from January 2016 to December 2018 in Hospital Clínico Regional Concepción, Chile. After the ethics committee\'s approval, we reviewed the database and surgical protocols. We used Chi-square and U Mann Whitney tests for statistical analysis (SPSSv25®), considering significant p < 0,05.
RESULTS: We analyzed 1,400 isolated CABG, 658 from the first period and 742 from the second, with a mean age of 62.0 ± 8.7 and 64.6 ± 9.3 respectively (p < 0.001). The subgroup with ventricular dysfunction in the second period showed a significant increase in diabetes mellitus, chronic obstructive pulmonary disease, acute myocardial infarction (AMI), and severe ventricular dysfunction. The second group decreased off-pump surgery and increased the use of ≥ 2 arterial grafts (p < 0.05). The Additive EuroSCORE I increased from 3.6 ± 2.5 to 4.4 ± 2.7 (p = 0.001). High-risk subgroup: 137 (20.8%) to 236 (31.8%), p < 0.001. Mortality of 13 (1.98%) and 16 (2.2%) in the first and second group respectively, p = 0.813.
CONCLUSIONS: There was a significant increase in the estimated surgical risk; however, mortality remained unchanged. The increase in surgical risk is consistent with the increase in mean age and prevalence of comorbidities, as well as the increase in severe ventricular dysfunction in the group ofpatients with ventricular dysfunction and recent AMI in the second period.
摘要：
背景：几个因素干预冠状动脉旁路移植术（CABG）特征的演变，例如人口变化，外科技术,围手术期护理。我们的目的是分析接受CABG治疗的患者冠状动脉疾病特征的演变及其近期结果。
方法：在一项分析研究中，我们分析了2006年1月至2008年12月和2016年1月至2018年12月在康塞普西翁医院接受孤立CABG的患者队列，智利。伦理委员会批准后,我们回顾了数据库和手术方案.我们使用卡方检验和UMannWhitney检验进行统计分析(SPSSv25®)，考虑到显著的p<0.05。
结果：我们分析了1,400个分离的CABG，第一阶段为658，第二阶段为742，平均年龄分别为62.0±8.7和64.6±9.3（p<0.001）。在第二个时期有心室功能障碍的亚组显示糖尿病的显着增加，慢性阻塞性肺疾病,急性心肌梗死(AMI),和严重的心室功能障碍.第二组减少了非体外循环手术，增加了≥2个动脉移植物的使用（p<0.05）。添加剂EuroSCOREI从3.6±2.5增加到4.4±2.7(p=0.001)。高危亚组：137（20.8%）至236（31.8%），p<0.001。第一组和第二组的死亡率分别为13（1.98％）和16（2.2％），p=0.813。
结论：估计的手术风险显著增加；然而，死亡率保持不变。手术风险的增加与平均年龄和合并症患病率的增加是一致的，以及在第二时期有心室功能障碍和近期AMI的患者组中严重心室功能障碍的增加。
方法：在一项分析研究中，我们分析了2006年1月至2008年12月和2016年1月至2018年12月在康塞普西翁医院接受孤立CABG的患者队列，智利。伦理委员会批准后,我们回顾了数据库和手术方案.我们使用卡方检验和UMannWhitney检验进行统计分析(SPSSv25®)，考虑到显著的p<0.05。
结果：我们分析了1,400个分离的CABG，第一阶段为658，第二阶段为742，平均年龄分别为62.0±8.7和64.6±9.3（p<0.001）。在第二个时期有心室功能障碍的亚组显示糖尿病的显着增加，慢性阻塞性肺疾病,急性心肌梗死(AMI),和严重的心室功能障碍.第二组减少了非体外循环手术，增加了≥2个动脉移植物的使用（p<0.05）。添加剂EuroSCOREI从3.6±2.5增加到4.4±2.7(p=0.001)。高危亚组：137（20.8%）至236（31.8%），p<0.001。第一组和第二组的死亡率分别为13（1.98％）和16（2.2％），p=0.813。
结论：估计的手术风险显著增加；然而，死亡率保持不变。手术风险的增加与平均年龄和合并症患病率的增加是一致的，以及在第二时期有心室功能障碍和近期AMI的患者组中严重心室功能障碍的增加。
