title: Prognostic impact of intra-aortic balloon pump insertion before versus after cardiac surgical intervention in a veteran population.
abstract: BACKGROUND
  The relative prognostic impact of intra-aortic balloon pump (IABP) placement before versus after cardiac surgery is not well defined.
  
  
  METHODS
  We reviewed data from all cardiac surgical patients who received perioperative IABP support at a veterans' hospital between April 1992 and April 2008. We compared outcomes between patients who received an IABP before surgery (BS, n = 36) and after surgery (AS, n = 28).
  
  
  RESULTS
  The AS group had higher operative morbidity (71% vs 42%) and mortality (43% vs 14%) rates than the BS group (P < .02 for both). Furthermore, survival rates were lower in the AS group than in the BS group at 1 year (50% vs 83%) and 3 years (46% vs 80%) (log-rank test, P < .004).
  
  
  CONCLUSIONS
  Patients who require IABP after cardiac surgery may have worse outcomes than patients who receive IABP support before surgery. In both groups, after an early peak in mortality, the midterm outcomes were characterized by a reassuring plateau in the survival rates.
authors.affiliation: Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Amandeep S
authors.initials: AS
authors.lastname: Dhaliwal
authors.forename: Danny
authors.initials: D
authors.lastname: Chu
authors.forename: Joseph
authors.initials: J
authors.lastname: Huh
authors.forename: Mued
authors.initials: M
authors.lastname: Ghadir
authors.forename: Shubhada
authors.initials: S
authors.lastname: Sansgiry
authors.forename: Prasad
authors.initials: P
authors.lastname: Atluri
authors.forename: Scott A
authors.initials: SA
authors.lastname: LeMaire
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Coselli
authors.forename: Faisal G
authors.initials: FG
authors.lastname: Bakaeen
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality*; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014728:Veterans