ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Ann Thorac Surg 2009;87:1820-1827. doi:10.1016/j.athoracsur.2009.03.052
© 2009 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Danny Chu
Faisal G. Bakaeen
Scott A. LeMaire
Joseph S. Coselli
Joseph Huh
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Chu, D.
Right arrow Articles by Huh, J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Chu, D.
Right arrow Articles by Huh, J.
Related Collections
Right arrow Coronary disease

Original Articles: Adult Cardiac

On-Pump Versus Off-Pump Coronary Artery Bypass Grafting in a Cohort of 63,000 Patients

Danny Chu, MDa,*, Faisal G. Bakaeen, MDa, Tam K. Dao, PhDb, Scott A. LeMaire, MDa,c, Joseph S. Coselli, MDa,c, Joseph Huh, MDa,c

a Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Texas
b Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
c Section of Adult Cardiac Surgery, The Texas Heart Institute at St. Luke's Episcopal Hospital, University of Houston, Houston, Texas

Accepted for publication March 17, 2009.

* Address correspondence to Dr Chu, Division of Cardiothoracic Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030 (Email: dchumd{at}gmail.com).

Presented at the Forty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Francisco, CA, Jan 26–28, 2009.

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.




This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
F. Formica
Reply to the Editor
J. Thorac. Cardiovasc. Surg., January 1, 2010; 139(1): 233 - 234.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2009 by The Society of Thoracic Surgeons.