Coronary artery bypass surgery in Syrian refugees Outcomes in a Turkish tertiary center

Objectives: To assess outcomes of Syrian refugees undergoing coronary artery bypass surgery in a tertiary hospital in Turkey. Methods: We sought for in-hospital mortality and one year all-cause mortality as the main outcomes. We reviewed records of 67 Syrian and 427 Turkish patients undergoing isolated coronary bypass surgery between 2015 January and 2017 January retrospectively. Results: History of coronary, peripheral and carotid artery diseases and obesity were more frequent in Syrian patients. C-reactive protein levels were higher in Syrian patients whereas lipid profiles and systolic functions of the 2 groups were similar. Syrian patients more frequently presented with the acute coronary syndrome (26.9% versus 15.5%, p<0.001). SYNTAX I (Synergy between PCI with Taxus and Cardiac Surgery) and SYNTAX II-PCI were higher in Syrian patients whereas SYNTAX II-CABG was similar with Turkish patients. Extubation time was longer and amount of the hemorrhage was greater in Syrian patients; however, bleeding revision was not increased. Although wound infection was more frequent in Syrian patients, postoperative complications were similar between groups. In-hospital mortality and one year all-cause mortality did not differ between Syrian (n=1; 1.5% versus n=13; 13.1%) (p=0.476) and Turkish patients (n=3; 4.5% versus n=25; 5.9%) (p=0.63). Conclusion: Syrian patients had higher SYNTAX I and SYNTAX II PCI scores, but not SYNTAX II CABG score compared with Turkish patients. Intraoperative and postoperative complications were similar. In-hospital mortality and one year all-cause mortality of Syrian patients were similar with Turkish patients. Surgical outcomes of Syrian patients were acceptable. Primary prevention of obesity must be provided. Aggressive secondary preventive measures must be taken due to increased severity of coronary artery disease.