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. 2022 Mar 21;17(1):45.
doi: 10.1186/s13019-022-01784-z.

Factors affecting mortality after coronary bypass surgery: a scoping review

Sean Christopher Hardiman  1 , Yuri Fabiola Villan Villan  2 , Jillian Michelle Conway  3 , Katie Jane Sheehan  4 , Boris Sobolev  5
Affiliations

Factors affecting mortality after coronary bypass surgery: a scoping review

Sean Christopher Hardiman et al. J Cardiothorac Surg. .

Abstract

Objectives: Previous research reports numerous factors of post-operative mortality in patients undergoing isolated coronary artery bypass graft surgery. However, this evidence has not been mapped to the conceptual framework of care improvement. Without such mapping, interventions designed to improve care quality remain unfounded.

Methods: We identified reported factors of in-hospital mortality post isolated coronary artery bypass graft surgery in adults over the age of 19, published in English between January 1, 2000 and December 31, 2019, indexed in PubMed, CINAHL, and EMBASE. We grouped factors and their underlying mechanism for association with in-hospital mortality according to the augmented Donabedian framework for quality of care.

Results: We selected 52 factors reported in 83 articles and mapped them by case-mix, structure, process, and intermediary outcomes. The most reported factors were related to case-mix (characteristics of patients, their disease, and their preoperative health status) (37 articles, 27 factors). Factors related to care processes (27 articles, 12 factors) and structures (11 articles, 6 factors) were reported less frequently; most proposed mechanisms for their mortality effects.

Conclusions: Few papers reported on factors of in-hospital mortality related to structures and processes of care, where intervention for care quality improvement is possible. Therefore, there is limited evidence to support quality improvement efforts that will reduce variation in mortality after coronary artery bypass graft surgery.

Keywords: Coronary artery bypass graft; Mortality; Scoping review.

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Conflict of interest statement

Sean Hardiman reports receiving salary from Cardiac Services BC outside of the submitted work. Katie Jane Sheehan received funding from the National Institute for Health Research (NIHR) and Chartered Society of Physiotherapy outside of the submitted work.

Figures

Fig. 1
Fig. 1
Flow chart of the literature, retrieval, review, exclusion, and selection process
Fig. 2
Fig. 2
Post-operative mortality factor groups within the augmented Donabedian framework
See this image and copyright information in PMC

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