DefinePK

Abstract

Background:  The Medical Procedure of coronary artery bypass grafting (CABG) stands as the recommended treatment option for severe coronary artery disease (CAD). The peripheral and extended outcomes post-operatively depend heavily on Left Ventricular Ejection Fraction (LVEF) as a vital risk assessment element. Patients who have preoperative LVEF in the low range stand at high risk because they face higher chances of cardiac morbidity that may lead to heart failure and death. Modern improvements in surgical practices in combination with advanced perioperative management strategies now enhance the survival rates of this specific patient population. Additional Study must assess CABG patient outcomes based on their LVEF status because this will improve risk assessment methods during the perioperative period.
Objectives: To compare the postoperative outcomes of CABG in patients with low (<40%) and normal (≥50%) preoperative ejection fraction. This investigation focuses on two key groups of patients who underwent CABG surgery including postoperative mortality and complications as well as required ICU stay time and extended survival metrics.
Study design: A retrospective cohort study.
Place and duration of study. From 01 July 2024 to 31 December 2024 Cardiology Department Sandeman Provincial Hospital / Bolan Medical Complex  Hospital Quetta.
Methods: A retrospective cohort analysis took place at Cardiology Department Sandeman Provincial Hospital / Bolan Medical Complex  Hospital Quetta between 01 Julay 2024 to 31 December 2024. A CABG surgery patient cohort received classification depending on preoperative LVEF measurement results with low EF below 40% and normal EF at 50% or above. Study physicians recorded baseline demographics together with comorbidities and operative details as well as postoperative outcomes findings. The Studyers analyzed data through SPSS while standard deviation (SD) and mean served to represent continuous variables and percentages showed categorical variables. The analysis used the chi-square test on categorical data and the independent t-test on continuous data types for group comparison. The study identified statistical significance when the p-value fell below 0.05.
Results: 50 patients who had 28 patients (44%) showing low ejection fraction (EF) while 22 patients had normal EF (56%). The participant sample matched across groups because their mean ages equalled 62.4 ± 8.7 years with no detected between-group differences (p = 0.32). The patients with lower ejection fraction experienced extended ICU hospitalizations (7.6 ± 2.1 days vs. 5.2 ± 1.8 days) and needed more inotropic medication (68% vs. 36%) according to analysis (p = 0.01 and p = 0.02 respectively). Hospital deaths were more frequent in the low EF patient group compared to the normal EF group (25% vs. 9%, p = 0.03). The one-year survival rates between both groups remained equivalent which did not demonstrate any statistically meaningful difference (p = 0.21).
Conclusion: The combination of reduced ejection fraction before surgery raises patients' risks of experiencing complications and death after CABG surgery but appropriate treatment enables them to achieve similar survival results. The high-risk patient population requires optimal perioperative procedures specialized hemodynamic support systems and comprehensive postoperative surveillance to obtain better outcomes. Additional large-scale Study studies with long-term tracking are essential to establish better management strategies and risk assessment approaches.