Economic outcome of off-pump coronary artery bypass surgery: a prospective randomized study.
BACKGROUND
Emphasis on cost containment in coronary artery bypass surgery is becoming increasingly important in modern hospital management. The revival of interest in off-pump (beating heart) coronary artery bypass surgery may influence the economic outcome. This study examines these effects.


METHODS
Two hundred patients undergoing first-time coronary artery bypass surgery were prospectively randomized to either conventional cardiopulmonary bypass and cardioplegic arrest or off-pump surgery. Variable and fixed direct costs were obtained for each group during operative and postoperative care. The data were analyzed using parametric methods.


RESULTS
There was no difference between the groups with respect to pre- and intraoperative patient variables. Off-pump surgery was significantly less costly than conventional on-pump surgery with respect to operating materials, bed occupancy, and transfusion requirements (total mean cost per patient: on pump, $3,731.6+/-1,169.7 vs off-pump, $2,615.13+/-953.6; p < 0.001). Morbidity was significantly higher in the on-pump group, which was reflected in an increased cost.


CONCLUSIONS
Off-pump revascularization offers a safe, cost-effective alternative to conventional coronary revascularization with cardiopulmonary bypass and cardioplegic arrest.
Ascione
R
R
Bristol Heart Institute, Bristol Royal Infirmary, United Kingdom.
Lloyd
C T
CT
Underwood
M J
MJ
Lotto
A A
AA
Pitsis
A A
AA
Angelini
G D
GD
D000368:Aged; D001803:Blood Transfusion / Q000191:economics; D002315:Cardiopulmonary Bypass / Q000191:economics*; D001026:Coronary Artery Bypass / Q000191:economics* / Q000379:methods; D017046:Cost Savings; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies