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Resource utilization in off-pump versus conventional coronary artery bypass grafting in a community hospital: a comparative analysis using propensity scoring.
Heart Surg Forum. 2011 Apr; 14(2):E81-6.HS

Abstract

BACKGROUND

At a time when cost containment in health care is under increased scrutiny, coronary artery bypass grafting remains the most widely performed cardiac surgical procedure in the world. This study compares 30-day mortality, morbidity, and resource use for off-pump coronary artery bypass (OPCAB) versus conventional coronary artery bypass (CCAB) revascularization.

METHODS

From January 2000 through December 2008, 1003 patients underwent OPCAB grafting by a single surgeon (S.C.S.). Data were prospectively collected, entered into a Society of Thoracic Surgeons adult cardiac surgery database, and analyzed retrospectively. We used propensity-matching techniques to match this cohort to a group of 1003 patients who underwent CCAB.

RESULTS

The hospital mortality rate was lower for the OPCAB patients than for the CCAB patients: 2.0% (20/1003) versus 2.8% (28/1003). Predictors of hospital mortality for the entire cohort included age (P = .001), cardiogenic shock (P = .001), congestive heart failure (P = .019), history of myocardial infarction (P = .001), and reoperation (P = .007). The overall incidence of morbidity was lower for the OPCAB patients (reoperation for bleeding, P = .011; prolonged ventilation, P = .035; stroke, P = .045; cardiac arrest, P = .004). OPCAB patients experienced significantly reduced procedure times (P = .001), postoperative ventilation times (P = .035), post-operative lengths of stay (P = .035), and blood product use (intraoperative, P = .001; postoperative, P = .001).

CONCLUSION

These outcomes clearly demonstrate that OPCAB is a safe and effective procedure for myocardial revascularization. This retrospective, nonrandomized observational study has shown that the patients who underwent OPCAB had reduced morbidity and mortality, as well as decreased resource use, compared with those who underwent CCAB.

Authors+Show Affiliations

Gulf Coast Cardiothoracic and Vascular Surgeons, Naples, Florida Naples Community Hospital, Naples, FL, USA. canes99@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21521681

Citation

Schultz, Scot C., et al. "Resource Utilization in Off-pump Versus Conventional Coronary Artery Bypass Grafting in a Community Hospital: a Comparative Analysis Using Propensity Scoring." The Heart Surgery Forum, vol. 14, no. 2, 2011, pp. E81-6.
Schultz SC, Woodward S, Ebra G. Resource utilization in off-pump versus conventional coronary artery bypass grafting in a community hospital: a comparative analysis using propensity scoring. Heart Surg Forum. 2011;14(2):E81-6.
Schultz, S. C., Woodward, S., & Ebra, G. (2011). Resource utilization in off-pump versus conventional coronary artery bypass grafting in a community hospital: a comparative analysis using propensity scoring. The Heart Surgery Forum, 14(2), E81-6. https://doi.org/10.1532/HSF98.201011115
Schultz SC, Woodward S, Ebra G. Resource Utilization in Off-pump Versus Conventional Coronary Artery Bypass Grafting in a Community Hospital: a Comparative Analysis Using Propensity Scoring. Heart Surg Forum. 2011;14(2):E81-6. PubMed PMID: 21521681.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resource utilization in off-pump versus conventional coronary artery bypass grafting in a community hospital: a comparative analysis using propensity scoring. AU - Schultz,Scot C, AU - Woodward,Scott, AU - Ebra,George, PY - 2011/4/28/entrez PY - 2011/4/28/pubmed PY - 2011/9/29/medline SP - E81 EP - 6 JF - The heart surgery forum JO - Heart Surg Forum VL - 14 IS - 2 N2 - BACKGROUND: At a time when cost containment in health care is under increased scrutiny, coronary artery bypass grafting remains the most widely performed cardiac surgical procedure in the world. This study compares 30-day mortality, morbidity, and resource use for off-pump coronary artery bypass (OPCAB) versus conventional coronary artery bypass (CCAB) revascularization. METHODS: From January 2000 through December 2008, 1003 patients underwent OPCAB grafting by a single surgeon (S.C.S.). Data were prospectively collected, entered into a Society of Thoracic Surgeons adult cardiac surgery database, and analyzed retrospectively. We used propensity-matching techniques to match this cohort to a group of 1003 patients who underwent CCAB. RESULTS: The hospital mortality rate was lower for the OPCAB patients than for the CCAB patients: 2.0% (20/1003) versus 2.8% (28/1003). Predictors of hospital mortality for the entire cohort included age (P = .001), cardiogenic shock (P = .001), congestive heart failure (P = .019), history of myocardial infarction (P = .001), and reoperation (P = .007). The overall incidence of morbidity was lower for the OPCAB patients (reoperation for bleeding, P = .011; prolonged ventilation, P = .035; stroke, P = .045; cardiac arrest, P = .004). OPCAB patients experienced significantly reduced procedure times (P = .001), postoperative ventilation times (P = .035), post-operative lengths of stay (P = .035), and blood product use (intraoperative, P = .001; postoperative, P = .001). CONCLUSION: These outcomes clearly demonstrate that OPCAB is a safe and effective procedure for myocardial revascularization. This retrospective, nonrandomized observational study has shown that the patients who underwent OPCAB had reduced morbidity and mortality, as well as decreased resource use, compared with those who underwent CCAB. SN - 1522-6662 UR - https://www.unboundmedicine.com/medline/citation/21521681/Resource_utilization_in_off_pump_versus_conventional_coronary_artery_bypass_grafting_in_a_community_hospital:_a_comparative_analysis_using_propensity_scoring_ DB - PRIME DP - Unbound Medicine ER -