Engin İhsan TURAN, Bedih BALKAN
Comprehensive Medicine - 2026;18(2):168-174
Objective: Coronary artery bypass grafting (CABG) and valve surgeries are vital for treating severe cardiac disease. Patients with reduced ejection fraction (EF) (<50%) have higher perioperative risks than those with preserved EF (>=50%). This study compares outcomes by EF and age (<65 vs. >=65 years) to support individualized management. Materials and Methods: This retrospective study included patients treated between 2018 and 2023. Patients were categorized by ejection fraction (EF) (preserved [>=50%] or reduced [<50%]) and age (<65 or >=65 years). The collected data included demographics, preoperative characteristics, intraoperative details, and postoperative outcomes (including transfusions, vasopressor use, arrhythmia, mortality, and intensive care unit stay duration). Results: Among 610 patients (354 with preserved EF and 256 with reduced EF), the reduced EF group required more perioperative noradrenaline (16.8% vs. 10.2%, p=0.01) and intensive care unit (ICU) adrenaline (14.5% vs. 8.8%, p=0.02). Perioperative arrhythmia was more frequent in reduced EF patients (67.2% vs. 57.1%, p=0.01). ICU stays were longer in the reduced EF group (4.75+/-7.44 vs. 3.28+/-4.98 days, p=0.02). Significant differences were observed in transfusion rates (intensive care unit (ICU): p <0.001) and pacing requirements (p=0.007). Mortality did not differ between groups. Subgroup comparisons showed significant differences in survival across age and EF categories (p=0.023) Conclusion: Reduced EF is associated with greater hemodynamic instability, higher arrhythmia incidence, and prolonged ICU stay. Age further influenced these outcomes, highlighting the need for individualized perioperative management strategies in high-risk cardiac surgery patients.
