BACKGROUND: The best approach to surgical myocardial revascularization remains controversial. We compared outcomes of conventional on-pump coronary artery bypass grafting (CABG) and off-pump coronary artery bypass (OPCAB) by using a nonvoluntary national database. METHODS: In the 2004 Nationwide Inpatient Sample database, we identified 63,047 discharge records of patients who underwent CABG (n = 48,658) or OPCAB (n = 14,389). We analyzed seven preoperative variables, including the Deyo comorbidity index and five outcome measures. Multivariable logistic regression was used to identify independent predictors of outcomes. RESULTS: CABG and OPCAB patients had similar demographics and comorbidities. They also had similar rates of in-hospital mortality (3.0% vs 3.2%; p = 0.14) and postoperative stroke (1.8% vs 1.7%; p = 0.53). However, OPCAB patients had longer hospital stays (10.2 +/- 9.4 vs 9.9 +/- 8.5 days; p < 0.0001) and higher hospital costs ($38,793 +/- $30,830 vs $37,806 +/- $28,705; p = 0.0005) than CABG patients. Multivariable regression analysis showed that OPCAB independently predicted 0.6 more days of hospital stay (95% confidence interval [CI], 0.4 to 0.8 day; R(2) = 0.09; p < 0.0001) and $1,497 more in hospital costs (95% CI, $779 to $2,216; R(2) = 0.09; p < 0.01) per patient. CONCLUSIONS: OPCAB does not produce lower postoperative mortality or stroke rates than CABG. Furthermore, OPCAB is associated with longer hospital stays and higher hospital costs.
BACKGROUND: The best approach to surgical myocardial revascularization remains controversial. We compared outcomes of conventional on-pump coronary artery bypass grafting (CABG) and off-pump coronary artery bypass (OPCAB) by using a nonvoluntary national database. METHODS: In the 2004 Nationwide Inpatient Sample database, we identified 63,047 discharge records of patients who underwent CABG (n = 48,658) or OPCAB (n = 14,389). We analyzed seven preoperative variables, including the Deyo comorbidity index and five outcome measures. Multivariable logistic regression was used to identify independent predictors of outcomes. RESULTS: CABG and OPCAB patients had similar demographics and comorbidities. They also had similar rates of in-hospital mortality (3.0% vs 3.2%; p = 0.14) and postoperative stroke (1.8% vs 1.7%; p = 0.53). However, OPCAB patients had longer hospital stays (10.2 +/- 9.4 vs 9.9 +/- 8.5 days; p < 0.0001) and higher hospital costs ($38,793 +/- $30,830 vs $37,806 +/- $28,705; p = 0.0005) than CABG patients. Multivariable regression analysis showed that OPCAB independently predicted 0.6 more days of hospital stay (95% confidence interval [CI], 0.4 to 0.8 day; R(2) = 0.09; p < 0.0001) and $1,497 more in hospital costs (95% CI, $779 to $2,216; R(2) = 0.09; p < 0.01) per patient. CONCLUSIONS: OPCAB does not produce lower postoperative mortality or stroke rates than CABG. Furthermore, OPCAB is associated with longer hospital stays and higher hospital costs.
Authors: Salil V Deo; Yakov Elgudin; A Laurie W Shroyer; Salah Altarabsheh; Vikas Sharma; Joseph Rubelowsky; Lorraine Cornwell; Piroze Davierwala; Danny Chu; Brian Cmolik Journal: J Am Heart Assoc Date: 2022-03-01 Impact factor: 6.106
Authors: J Fassl; H Riha; H Ramakrishna; N Singh; T Wyckoff; C Roscher; J G T Augoustides Journal: HSR Proc Intensive Care Cardiovasc Anesth Date: 2010