Emergency Coronary Artery Bypass Grafting and High In-Hospital Mortality in Patients with Preoperative Cardiopulmonary Resuscitation: A Single Hospital Observational Study

Background: Emergency coronary artery bypass grafting (CABG) presents significant challenges, particularly for cardiovascular surgeons dealing with acute cases of cardiogenic shock. While percutaneous coronary intervention (PCI) has shown efficacy in managing acute myocardial infarction (AMI) with cardiogenic shock, its limitations highlight the need for alternative interventions. This study evaluates prognostic factors in emergency CABG among AMI patients with and without cardiogenic shock. Methods: Over a three-year period, 47 patients undergoing emergency CABG for AMI were studied. Of these, 25 had cardiogenic shock, and 22 did not. Detailed retrospective chart reviews were conducted to identify preoperative risk factors and operative outcomes. Results: Among the cardiogenic shock patients, 56% received preoperative cardiopulmonary resuscitation (CPR), with a 40% in-hospital mortality rate. In contrast, 4% of patients without preoperative CPR succumbed. Key mortality predictors included preoperative CPR (P < .001), intra-aortic balloon pump insertion (P = .005), and endotracheal intubation (P = .039). Conclusions: The study confirms high mortality rates associated with emergency CABG in patients with preoperative CPR, while those without CPR exhibited better survival outcomes.