David Hermawan Christian, NIM011318236301 (2019) FAKTOR PREDIKTIF MORTALITAS PASIEN YANG MENJALANI OPERASI ON PUMP CORONARY ARTERY BYPASS GRAFTING DI RSUD DR. SOETOMO SURABAYA. Thesis thesis, Universitas Airlangga.

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Abstract

Background: Coronary heart disease is the most common cause of death in Indonesia and world. One treatment option for coronary heart disease is Coronary Artery Bypass Grafting (CABG). Although this operation has been developed, postoperative deaths are still present. The factor predictive of operative mortality following CABG surgery should be identified in order to minimize postoperative deaths. The purpose of this study is to identify factor predictive of postoperative mortality following on pump CABG in Dr. Soetomo Hospital Surabaya. Methods: This retrospective observational analytic study is using secondary data from medical records and Thoracic Cardiovascular Surgery Department database. Univariate and multivariate analysis using simple binary logistic regression with backward selection is done to identify mortality predictors with 95% confidence interval. Statistical analysis is done using SPSSv23. Result: 126 patients met the inclusion criteria, postoperative deaths were 10 (7.9%) patients. Univariate analysis showed that LIMA use (p = 0.013; OR = 5.46; 95% CI = 1.43-20.86); 1-2 bag PRC (p = 0.011; OR = 8.571; 95% CI = 1.63–44.95) and 3-5 bag PRC (p = 0.031; OR = 10; 95% CI = 1.24–80,88) transfusion; postoperative infection (p = 0.019; OR = 6,791; 95% CI = 1.38– 33.46), AF (p = 0.002; OR = 8,667; 95% CI = 2.19–34.32) and AKI (p = 0.019; OR = 5.282; 95 % CI = 1.32-21.22); duration of ventilator use (p = 0.022; OR = 1,014; 95% CI = 1–1.03); length of stay (p = 0.011; OR = 1,093; 95% CI = 1.02– 1.17) have a significant relationship with CABG postoperative mortality. Multivariate analysis showed postoperative AF (p = 0.012; OR = 7,941; 95% CI = 1.56–40.33) and infections (p = 0.04; OR = 6.915; 95% CI = 1.09–43.96) are predictors of postoperative death CABG. LIMA graft (p = 0.015; OR = 0.139; 95% CI = 0.03-0.68) provides protection against postoperative CABG mortality. Conclusion: LIMA graft, PRC transfusion, postoperative infection, AF, AKI, duration of ventilator, and length of stay are combined factors predictive with CABG postoperative mortality. LIMA graft is a protective factor against postoperative death CABG. Postoperative infection and AF are independent predictive factors of CABG postoperative mortality.

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