Short-term complications and resource utilization in matched subjects after on-pump or off-pump primary isolated coronary artery bypass.
BACKGROUND
Studies suggest that patients who undergo off-pump coronary artery bypass grafting (OPCABG) have fewer short-term complications and use fewer inpatient resources than do patients who undergo standard coronary artery bypass grafting (CABG) with extracorporeal circulation. However, dissimilarity between groups in risk factors for complications has hindered interpretation of results.


OBJECTIVE
To compare the prevalence of selected complications (atrial fibrillation, stroke, reoperation, and bleeding) and inpatient resource utilization (length of stay, discharge disposition, total charges) between subjects undergoing primary isolated CABG or OPCABG who were matched with respect to key risk factors.


METHODS
Retrospective, causal-comparative survey conducted in 1 center for 18 months. Patients who underwent primary isolated CABG or OPCABG were matched for sex, age (within 2 years), left ventricular ejection fraction (within 0.05), and graft-patient ratio (exact match) and compared for prevalence of new-onset atrial fibrillation, stroke, reoperation within 24 hours, and bleeding. Statistical analysis included Wilcoxon and t tests for paired comparisons.


RESULTS
The sample (107 matched pairs) was 63% male, with a mean age of 66 (SD 9.5) years, a mean left ventricular ejection fraction of 0.51 (SD 0.13), and a mean graft-patient ratio of 3.41 (SD 0.74). The 2 groups did not differ significantly in New York Heart Association class (P = .43), Acute Physiology and Chronic Health Evaluation III score (P = .22), postoperative beta-blocker use (P = .73), or comorbid conditions. None of the complications examined differed significantly between pairs.


CONCLUSIONS
Patients with comparable risk profiles have similar prevalences of selected complications after CABG and OPCABG.
Hravnak
Marilyn
M
Department of Acute/Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, Pa., USA.
Hoffman
Leslie A
LA
Saul
Melissa I
MI
Zullo
Thomas G
TG
Cuneo
Julie F
JF
Pellegrini
Ronald V
RV
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000191:economics / Q000401:mortality; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000191:economics / Q000379:methods* / Q000401:mortality; D019992:Databases as Topic; D005260:Female; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D013318:Stroke Volume / Q000502:physiology
D000319:Adrenergic beta-Antagonists