What databases report Coronary Artery Bypass Graft (CABG) outcomes using 5-year or 10-year prediction models for mortality or revascularization, including tobacco use and/or Body Mass Index (BMI)?

From the Guidelines

The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database is the most recommended resource for CABG outcome reporting with long-term prediction models that include tobacco use and BMI, as it provides comprehensive risk prediction models for 5-year and 10-year mortality and revascularization rates. Several databases offer valuable insights into CABG outcomes, including the Veterans Affairs Continuous Improvement in Cardiac Surgery Program (VA CICSP) database, the American College of Cardiology Foundation's National Cardiovascular Data Registry (NCDR), the European Association for Cardio-Thoracic Surgery (EACTS) database, and the New York State Cardiac Surgery Reporting System 1.

When evaluating these databases, it is crucial to consider the impact of tobacco use and BMI on long-term CABG outcomes, as both factors significantly influence morbidity, mortality, and quality of life. According to recent studies, severe obesity (BMI ≥40) is associated with higher long-term mortality post-CABG, while underweight patients are at increased risk of peri-operative bleeding and mortality 1.

Key factors to consider when accessing these databases include:

• Specifying research parameters to focus on long-term (5-10 year) outcomes
• Ensuring tobacco use and BMI are included as variables in the prediction models
• Understanding the mechanisms by which smoking and obesity impact CABG outcomes, such as endothelial dysfunction, increased inflammation, and accelerated atherosclerosis
• Recognizing the importance of accurate risk prediction tools, like the STS-PROM score, in evaluating the potential benefit of revascularization against procedural risk 1.

By prioritizing the STS Adult Cardiac Surgery Database and considering these key factors, clinicians can make informed decisions about CABG outcomes and develop effective strategies to improve patient morbidity, mortality, and quality of life.

From the Research

Databases with CABG Outcome Reporting

• There are several studies that report on the outcomes of Coronary Artery Bypass Graft (CABG) surgery, including 5-year and 10-year prediction models on mortality or revascularization 2, 3, 4, 5, 6.
• These studies include data on various risk factors, such as tobacco use and Body Mass Index (BMI), that can affect CABG outcomes.

Risk Factors and CABG Outcomes

• Tobacco use has been identified as a significant risk factor for adverse outcomes after CABG surgery, including increased risk of mortality and revascularization 4.
• BMI has also been shown to be a risk factor for CABG outcomes, with obese patients having a higher risk of complications and mortality 5.
• Other risk factors, such as hypertension, hyperlipidemia, and diabetes, have also been identified as significant predictors of CABG outcomes 4, 6.

Prediction Models for CABG Outcomes

• Several studies have developed prediction models for CABG outcomes, including 5-year and 10-year mortality and revascularization rates 2, 5.
• These models often include a range of risk factors, such as age, sex, comorbidities, and lifestyle factors, to predict individual patient outcomes.
• However, there is limited information available on databases that specifically report on 5-year or 10-year prediction models for CABG outcomes that include tobacco use and/or BMI as risk factors.

Available Data and Studies

• The available studies provide valuable insights into the outcomes of CABG surgery and the risk factors that affect these outcomes 2, 3, 4, 5, 6.
• However, there is a need for further research and data collection to develop more accurate and comprehensive prediction models for CABG outcomes that include tobacco use and/or BMI as risk factors.