On-pump versus off-pump coronary artery bypass surgery in a matched sample of women: a comparison of outcomes.
BACKGROUND
Women have consistently higher mortality and morbidity than men after coronary artery bypass grafting (CABG). Whether elimination of cardiopulmonary bypass and performance of coronary artery bypass grafting off-pump (OPCAB) have a beneficial effect specifically in women has not been defined.


RESULTS
From January 1998 through March 2002, 21 902 consecutive female patients at 82 hospitals underwent isolated CABG, as reported in an administrative database. Propensity score computer matching was performed based on 13 variables representing patient characteristics and preoperative risk factors to correct for and minimize selection bias. A total of 7376 (3688 pairs) women undergoing CABG surgery were able to be successfully matched. In a propensity score computer-matched cohort, multivariate logistic regression (odds ratio) revealed that women undergoing on-pump surgery had a 73.3% higher mortality (P=0.002) and a 47.2% higher risk of bleeding complications (P=0.019).


CONCLUSIONS
In a retrospective analysis of women undergoing CABG, computer-matched to minimize selection bias, off-pump surgery led to decreased mortality and morbidity including bleeding complications.
Mack
Michael J
MJ
HCA, Inc, Nashville, Tenn, USA. smullins@csant.com
Brown
Phillip
P
Houser
Frank
F
Katz
Mark
M
Kugelmass
Aaron
A
Simon
April
A
Battaglia
Salvatore
S
Tarkington
Lynn
L
Culler
Steven
S
Becker
Edmund
E
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000401:mortality / Q000706:statistics & numerical data*; D047549:Coronary Artery Bypass, Off-Pump / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome