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Clinical Profiles and Outcomes of Patients Who Underwent Coronary Artery Bypass Graft Procedures at Manila Doctors Hospital from May 1, 2009 to December 31, 2015

Emmanuel Raymundo M.D.
Luminardo Ramos M.D. & Dante Morales M.D.**

ABSTRACT

Introduction: Coronary artery disease is the number one cause of death worldwide. It causes a tremendous health burden both to the patient and society. In the Philippines, it is also the number one cause of death. Coronary artery bypass surgery was developed to treat patients with coronary artery disease. In May 2009, coronary artery bypass procedures were started in Manila Doctors Hospital. However, local studies which describe number of patients, clinical profile, EuroSCOREs, coronary angiogram results, ejection fraction results, types of bypass graft procedures, and any morbidities or mortalities encountered, are not available. Thus, the objective of this study is to describe these parameters.
Methodology: Clinical case records of patients 18 years old and above who were admitted at Manila Doctors Hospital, and underwent coronary artery bypass graft procedures were gathered from the Records Section, and reviewed. Data on number of patients, clinical profile, EuroSCOREs, coronary angiogram results, ejection fraction results, types of bypass graft procedures, and any morbidities or mortalities encountered were collected, tabulated, and subjected to descriptive statistics using Microsoft Excel.
Results: 173 patients underwent coronary artery bypass graft procedures from May 1, 2009 to December 31, 2015. Age ranged from 34-87 years old, with an average of 60.88 ± 8.50 years old. The majority were male, (n=151, 87%), while the females were at 22 (13%). Body mass index showed half were in the normal range (n=86), while 36% were overweight (n=63), 23% were obese (n=23) and 1% was underweight (n=1). Average length of stay was 4.6 ± 2.96 days in the coronary care unit (CCU), and 16.93 ± 8.16 total hospital days. Hypertension (n=145, 84%), previous myocardial infarction (n=112, 65%), diabetes mellitus (n=97, 56%), dyslipidemia (n=43, 25%), chronic re nal disease (n=35, 21%) were the most common comorbidities. 62% of patients were smokers, while 47% were alcoholic drinkers. All denied drug use. Coronary angiogram studies showed 87% of patients with at least three-vessel disease, 11% with two-vessel, 2% with one-vessel disease. Average ejection fraction for these patients was at 57.72% ± 0.16. The computed EuroSCORE was at 1.96% ± 0.016. 87% of patients underwent 3 or more vessel bypass procedures, 7% underwent vessel bypass with a concurrent valve procedure, and 6% of patients underwent less than 3 vessel bypass procedures. 83% of procedures were done on an urgent basis, 16% on an elective basis, and 1% on an emergent basis. 7 procedures resulted in morbidities, while 9 procedures resulted in mortalities.
Conclusion: Over the past 7 years, patient demographics have not changed for age and gender. Despite increasing number of procedures being done, the length of stay, morbidity and mortality rates have decreased over time.

**Advisers/Consultants, Department of Surgery

2018-03-06T11:51:06+00:00