Literature DB >> 15568655

Short-term complications and resource utilization in matched subjects after on-pump or off-pump primary isolated coronary artery bypass.

Marilyn Hravnak1, Leslie A Hoffman, Melissa I Saul, Thomas G Zullo, Julie F Cuneo, Ronald V Pellegrini.   

Abstract

BACKGROUND: Studies suggest that patients who undergo off-pump coronary artery bypass grafting (OPCABG) have fewer short-term complications and use fewer inpatient resources than do patients who undergo standard coronary artery bypass grafting (CABG) with extracorporeal circulation. However, dissimilarity between groups in risk factors for complications has hindered interpretation of results.
OBJECTIVES: To compare the prevalence of selected complications (atrial fibrillation, stroke, reoperation, and bleeding) and inpatient resource utilization (length of stay, discharge disposition, total charges) between subjects undergoing primary isolated CABG or OPCABG who were matched with respect to key risk factors.
METHODS: Retrospective, causal-comparative survey conducted in 1 center for 18 months. Patients who underwent primary isolated CABG or OPCABG were matched for sex, age (within 2 years), left ventricular ejection fraction (within 0.05), and graft-patient ratio (exact match) and compared for prevalence of new-onset atrial fibrillation, stroke, reoperation within 24 hours, and bleeding. Statistical analysis included Wilcoxon and t tests for paired comparisons.
RESULTS: The sample (107 matched pairs) was 63% male, with a mean age of 66 (SD 9.5) years, a mean left ventricular ejection fraction of 0.51 (SD 0.13), and a mean graft-patient ratio of 3.41 (SD 0.74). The 2 groups did not differ significantly in New York Heart Association class (P = .43), Acute Physiology and Chronic Health Evaluation III score (P = .22), postoperative beta-blocker use (P = .73), or comorbid conditions. None of the complications examined differed significantly between pairs.
CONCLUSION: Patients with comparable risk profiles have similar prevalences of selected complications after CABG and OPCABG.

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Year:  2004        PMID: 15568655      PMCID: PMC3655795     

Source DB:  PubMed          Journal:  Am J Crit Care        ISSN: 1062-3264            Impact factor:   2.228


  25 in total

1.  Blood product use in cardiac revascularization: comparison of on- and off-pump techniques.

Authors:  N D Nader; W Z Khadra; N T Reich; D R Bacon; T A Salerno; A L Panos
Journal:  Ann Thorac Surg       Date:  1999-11       Impact factor: 4.330

2.  Neuromonitoring and neurocognitive outcome in off-pump versus conventional coronary bypass operation.

Authors:  A Diegeler; R Hirsch; F Schneider; L O Schilling; V Falk; T Rauch; F W Mohr
Journal:  Ann Thorac Surg       Date:  2000-04       Impact factor: 4.330

3.  Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery.

Authors:  M F Newman; J L Kirchner; B Phillips-Bute; V Gaver; H Grocott; R H Jones; D B Mark; J G Reves; J A Blumenthal
Journal:  N Engl J Med       Date:  2001-02-08       Impact factor: 91.245

4.  Elimination of cardiopulmonary bypass improves early survival for multivessel coronary artery bypass patients.

Authors:  Mitchell J Magee; Kathleen A Jablonski; Sotiris C Stamou; Albert J Pfister; Todd M Dewey; Mercedes K C Dullum; James R Edgerton; Syma L Prince; Tea E Acuff; Paul J Corso; Michael J Mack
Journal:  Ann Thorac Surg       Date:  2002-04       Impact factor: 4.330

5.  Cognitive outcome after off-pump and on-pump coronary artery bypass graft surgery: a randomized trial.

Authors:  Diederik Van Dijk; Erik W L Jansen; Ron Hijman; Arno P Nierich; Jan C Diephuis; Karel G M Moons; Jaap R Lahpor; Cornelius Borst; Annemieke M A Keizer; Hendrik M Nathoe; Diederick E Grobbee; Peter P T De Jaegere; Cor J Kalkman
Journal:  JAMA       Date:  2002-03-20       Impact factor: 56.272

6.  Coronary artery bypass grafting with and without cardiopulmonary bypass: a comparison analysis.

Authors:  K C Kirk; R A Aldridge; J J Sistino; J L Zellner; A J Crumbley; J M Kratz; F A Crawford; S T Reeves
Journal:  J Extra Corpor Technol       Date:  2001-05

7.  Postoperative atrial fibrillation: a comparison of off-pump coronary artery bypass surgery and conventional coronary artery bypass graft surgery.

Authors:  D G Place; R A Peragallo; J Carroll; R J Cusimano; D C H Cheng
Journal:  J Cardiothorac Vasc Anesth       Date:  2002-04       Impact factor: 2.628

8.  Clinical outcomes and resource usage in 100 consecutive patients after off-pump coronary bypass procedures.

Authors:  J H Lee; K Abdelhady; M Capdeville
Journal:  Surgery       Date:  2000-10       Impact factor: 3.982

9.  Humoral immune response during coronary artery bypass grafting: A comparison of limited approach, "off-pump" technique, and conventional cardiopulmonary bypass.

Authors:  A Diegeler; N Doll; T Rauch; D Haberer; T Walther; V Falk; J Gummert; R Autschbach; F W Mohr
Journal:  Circulation       Date:  2000-11-07       Impact factor: 29.690

10.  Off-pump coronary artery bypass grafting decreases risk-adjusted mortality and morbidity.

Authors:  J C Cleveland; A L Shroyer; A Y Chen; E Peterson; F L Grover
Journal:  Ann Thorac Surg       Date:  2001-10       Impact factor: 4.330

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  3 in total

Review 1.  Neurologic complications of cardiac surgery: current concepts and recent advances.

Authors:  David J Bronster
Journal:  Curr Cardiol Rep       Date:  2006-02       Impact factor: 2.931

2.  Incidence of atrial fibrillation after off-pump versus on-pump coronary artery bypass grafting: A meta-analysis of randomized clinical trials and propensity score matching trials.

Authors:  Chuang-Yan Wu; Si-Hua Wang; Yu-Qiang Shang; Jia-Hong Xia
Journal:  J Huazhong Univ Sci Technolog Med Sci       Date:  2017-12-21

3.  Sex differences in resource use after on-pump and off-pump coronary artery bypass surgery: a propensity score-matched cohort.

Authors:  Manjula Maganti; Vivek Rao; Robert J Cusimano
Journal:  Can J Cardiol       Date:  2009-05       Impact factor: 5.223

  3 in total

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