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Risk factors for hemorrhage-related reexploration and blood transfusion after conventional versus coronary revascularization without cardiopulmonary bypass.
Eur J Cardiothorac Surg. 2005 Mar; 27(3):494-500.EJ

Abstract

OBJECTIVE

The premise of coronary revascularization without cardiopulmonary bypass (off-pump CABG) proposes that patient morbidity and, potentially, mortality can be reduced without compromising the excellent results of conventional revascularization techniques (on-pump CABG). It is unknown, however, whether coronary artery bypass without cardiopulmonary bypass (off-pump CABG) is associated with similar hemorrhage related reexploration rates and blood transfusion requirements compared to the on-pump approach.

METHODS

Between January 1998 and June 2002, 3646 patients underwent off-pump CABG and were compared with a contemporaneous control group of 5197 on-pump CABG patients. A logistic regression model was used to test the difference in the postoperative hemorrhage related reexploration rates and need for postoperative blood transfusions between the groups, controlling for preoperative risk factors. The patients undergoing off-pump CABG were matched to on-pump patients by propensity score.

RESULTS

Hemorrhage related reexploration rates were comparable between the 2 groups (odds-ratio [OR]=0.80, 95% confidence intervals [CI]=0.55-1.09, P=0.15). Off-pump CABG was associated with a lower need for single and multiple unit postoperative blood transfusions (OR=0.30, CI=0.24-0.31, P<0.01 and OR=0.4, CI=0.36-0.51, P<0.01, respectively) compared to on-pump CABG patients.

CONCLUSIONS

Off-pump CABG eliminates the risks of cardiopulmonary bypass and the systemic inflammatory response it elicits. A substantially lower need for postoperative blood transfusions and a comparable hemorrhage-related reexploration rate suggests that off-pump CABG may avoid the morbidity and mortality associated with excessive postoperative blood loss.

Authors+Show Affiliations

Section of Cardiac Surgery, Washington Hospital Center, Washington, DC, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15740962

Citation

Frankel, Timothy L., et al. "Risk Factors for Hemorrhage-related Reexploration and Blood Transfusion After Conventional Versus Coronary Revascularization Without Cardiopulmonary Bypass." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 27, no. 3, 2005, pp. 494-500.
Frankel TL, Stamou SC, Lowery RC, et al. Risk factors for hemorrhage-related reexploration and blood transfusion after conventional versus coronary revascularization without cardiopulmonary bypass. Eur J Cardiothorac Surg. 2005;27(3):494-500.
Frankel, T. L., Stamou, S. C., Lowery, R. C., Kapetanakis, E. I., Hill, P. C., Haile, E., & Corso, P. J. (2005). Risk factors for hemorrhage-related reexploration and blood transfusion after conventional versus coronary revascularization without cardiopulmonary bypass. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 27(3), 494-500.
Frankel TL, et al. Risk Factors for Hemorrhage-related Reexploration and Blood Transfusion After Conventional Versus Coronary Revascularization Without Cardiopulmonary Bypass. Eur J Cardiothorac Surg. 2005;27(3):494-500. PubMed PMID: 15740962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for hemorrhage-related reexploration and blood transfusion after conventional versus coronary revascularization without cardiopulmonary bypass. AU - Frankel,Timothy L, AU - Stamou,Sotiris C, AU - Lowery,Robert C, AU - Kapetanakis,Emmanouil I, AU - Hill,Peter C, AU - Haile,Elizabeth, AU - Corso,Paul J, Y1 - 2004/12/30/ PY - 2004/07/07/received PY - 2004/11/11/revised PY - 2004/11/23/accepted PY - 2005/3/3/pubmed PY - 2005/4/26/medline PY - 2005/3/3/entrez SP - 494 EP - 500 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 27 IS - 3 N2 - OBJECTIVE: The premise of coronary revascularization without cardiopulmonary bypass (off-pump CABG) proposes that patient morbidity and, potentially, mortality can be reduced without compromising the excellent results of conventional revascularization techniques (on-pump CABG). It is unknown, however, whether coronary artery bypass without cardiopulmonary bypass (off-pump CABG) is associated with similar hemorrhage related reexploration rates and blood transfusion requirements compared to the on-pump approach. METHODS: Between January 1998 and June 2002, 3646 patients underwent off-pump CABG and were compared with a contemporaneous control group of 5197 on-pump CABG patients. A logistic regression model was used to test the difference in the postoperative hemorrhage related reexploration rates and need for postoperative blood transfusions between the groups, controlling for preoperative risk factors. The patients undergoing off-pump CABG were matched to on-pump patients by propensity score. RESULTS: Hemorrhage related reexploration rates were comparable between the 2 groups (odds-ratio [OR]=0.80, 95% confidence intervals [CI]=0.55-1.09, P=0.15). Off-pump CABG was associated with a lower need for single and multiple unit postoperative blood transfusions (OR=0.30, CI=0.24-0.31, P<0.01 and OR=0.4, CI=0.36-0.51, P<0.01, respectively) compared to on-pump CABG patients. CONCLUSIONS: Off-pump CABG eliminates the risks of cardiopulmonary bypass and the systemic inflammatory response it elicits. A substantially lower need for postoperative blood transfusions and a comparable hemorrhage-related reexploration rate suggests that off-pump CABG may avoid the morbidity and mortality associated with excessive postoperative blood loss. SN - 1010-7940 UR - https://www.unboundmedicine.com/medline/citation/15740962/Risk_factors_for_hemorrhage_related_reexploration_and_blood_transfusion_after_conventional_versus_coronary_revascularization_without_cardiopulmonary_bypass_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1016/j.ejcts.2004.11.021 DB - PRIME DP - Unbound Medicine ER -