• Journal of Chest Surgery
• /
• v.37 no.9
• /
• pp.749-754
• /
• 2004

Off-pump coronary artery bypass grafting (Off-Pump CABG) has been proven to have less morbidity and to facilitate early recovery. High-risk surgical patients may have benefitted by avoiding the adverse effects of the cardiopulmonary bypass. We compared the effectiveness of Off-Pump CABG with that of coronary artery bypass using cardiopulmonary bypass (On-Pump CABG) in high-risk patients. Material and Method: 682 patients (424 Off-Pump CABG and 258 On-Pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Patients who were considered high risk were selected High risk is defined as the presence of one or more of nine adverse prognostic factors. Data were collected from 492 patients in Off-Pump CABG and 100 in On-Pump CABG for risk factors, extent of coronary disease, and in-hospital outcomes. Result： Off-Pump CABG group and On-Pump CABG group did not show differences in their preoperative risk factors. We used more arterial grafts in Off-Pump CABG group (p < 0.05). Postoperative results showed that operative mortality (0.5% in Off-Pump CABG versus 2.0% in On-Pump CABG), renal failure (2.6% in Off-Pump CABG versus 7.0% in On-Pump CABG), and perioperative myocardial infarction (1.5% in Off-Pump CABG versus 1.0% in On-Pump CABG) did not differ significantly. However, Off-Pump CABG had shorter mean operation time (p<0.05), lower mean CK-MB level (p <0.05), lower rate of usage of inotropics (p < 0.05), shorter mean ventilation time (p <0.05), lower perioperative stroke (0% versus 2.0%), and shorter length of stay (p < 0.05) than On-Pump CABG. On-Pump CABG had more distal grafts (p<0.05) than Off-Pump CABG. Although Off-Pump CABG and On-Pump CABG did not show statistical differences in mortality and morbidity was more frequent in CABG. Conclusion: Off-Pump CABG reduces morbidity and favors hospital outcomes. Therefore, Off-Pump CABG is safe, reasonable and may be a preferable operative strategy for high-risk patients.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.9
• /
• pp.6080-6088
• /
• 2015

The purpose of study is to find difference in the quality of life and related factors according to the employment status. Using data from the fifth National Health and Nutrition Survey, economically active population of 20-69 years old 3,429 participants who said to questions of 'economic activity status' were finally used as analysis subjects in Korea. According to economic activity status, individuals were divided by the six different employment status and their quality of life was inspected using the EQ-5D dimensions and index score as well as analyzing the factors affecting the quality of life. As a result, unemployed compared to full-time workers, had significantly higher needs of four dimensions and Unpaid family workers had in the dimensions of Mobility, Self-care and Usual activities and temporary job had in the dimensions of Self-care and Usual activities. After figuring out life quality factors according to employment status, it was found that compared to full-time workers greater age(${\beta}=-0.089$, p<0.001), more stress(${\beta}=-0.143$, p<0.0001), hyperlipidemia(${\beta}=-0.064$, p<0.0001), stroke, arthritis(${\beta}=-0.160$, p<0.0001), respiratory diseases(${\beta}=-0.055$, p<0.001) and chronic health conditions were more influential to low quality of life for temporary job(${\beta}=-0.034$, p<0.05), day workers(${\beta}=-0.078$, p<0.0001) and unemplyed(${\beta}=-0.052$, p<0.01). The study is reported that it is to find difference in the quality of life and related factors according to the employment status and it is considered to provide basis for health evaluation of utilization in the same field of study.

• Journal of Chest Surgery
• /
• v.38 no.2 s.247
• /
• pp.123-131
• /
• 2005

Background: The number of elderly patients undergoing coronary artery bypass grafting (CABG) is increasing. Elderly patients are at increased risk for a variety of perioperative complications and mortality. We identified determinants of operative complications and mortality in elderly patients undergoing CABG. Material and Method: Between January 1995 and July 2003, 91 patients older than 75 years underwent isolated CABG at Asan Medical Center. There were 67 men and 24 women with mean age of $77.0\pm2.4$ years. Thirty clinical or hemodynamic variables hypothesized as predictors of operative mortality were evaluated. Result: CABG was performed under emergency conditions in 5 patients. The internal thoracic artery was used in 85 patients and 10 patients received both internal thoracic arteries. The mean number of distal anastomosis was 3.7 per patient. Operative mortality was $3.3\%$. Twenty-two patients had at least one major postoperative complication. Low cardiac output syndrome was the most common complication, followed by reoperation for bleeding, pulmonary dysfunction, perioperative myocardial infarction, stroke, acute renal failure, ventricular arrhythmia, upper gastrointestinal bleeding, infection, and delayed sternal closure. None were the predictors of mortality. Renal failure, peripheral vascular disease, emergency operation, recent myocardial infarction, congestive heart failure, New York Heart Association (HYHA) class III or IV, Canadian Cardiovascular Society (CCS) angina scale III or IV, and low left ventricle ejection fraction below $40\%$ were univariate predictors of overall complications. Actuarial probability of survival was $94.9\%,\;89.8\%,\;and\;83.5\%$ at postoperative 1, 3 and 5 years respectively. During the follow-up period $93.3\%$ of patients were in NYHA class I, or II and $91.1\%$ were free from angina. Conclusion: Although operative complication is increased, CABG can be performed with an acceptable operative mortality and excellent late results in patients older than 75 years.