title: Critical Outcomes in Nonrobotic vs Robotic-Assisted Cardiac Surgery.
abstract: OBJECTIVE
  As robotic-assisted cardiac surgical procedures increase nationwide, surgeons need to be educated on the safety of the new modality compared with that of open technique.
  
  
  OBJECTIVE
  To compare complications, length of stay (LOS), actual cost, and mortality between nonrobotic and robotic-assisted cardiac surgical procedures.
  
  
  METHODS
  Weighted data on cardiac patients who had undergone operations involving the valves or septa and vessels, as well as other heart and pericardium procedures, from January 1, 2008, to December 31, 2011, were obtained from the Nationwide Inpatient Sample via the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. Propensity score matching was used to match each robotic-assisted case to 2 nonrobotic cases on 14 characteristics.
  
  
  METHODS
  Complications, median LOS, actual cost, and mortality.
  
  
  RESULTS
  Exploratory analysis found a total of 1,374,653 cardiac cases (1,369,454 [99.6%] nonrobotic and 5199 [0.4%] robotic-assisted cases). After propensity score matching, there were 10,331 (66.5%) nonrobotic cases and 5199 (33.5%) robotic-assisted cases. Cardiac operations included 1630 (10.5%) involving the valves or septa, 6616 (42.6%) involving the vessels, and 7284 (46.9%) other heart and pericardium procedures. Robotic-assisted compared with nonrobotic surgery had a higher median cost ($39,030 vs $36,340; P < .001) but lower LOS (5 vs 6 days; P < .001) and lower mortality (1.0% vs 1.9%; P < .001). Robotic-assisted surgery had significantly fewer complications for all operation types (30.3% vs 27.2%; P < .001).
  
  
  CONCLUSIONS
  Overall, robotic-assisted surgery has significantly reduced median LOS, complications, and mortality compared with nonrobotic surgery. Results of this study support the contention that robotic-assisted surgery is as safe as nonrobotic surgery and offers the surgeon an additional technique for performing cardiac surgery.
authors.affiliation: Department of General Surgery, York Hospital, York, Pennsylvania.
authors.forename: Franz
authors.initials: F
authors.lastname: Yanagawa
authors.affiliation: Department of General Surgery, York Hospital, York, Pennsylvania.
authors.forename: Martin
authors.initials: M
authors.lastname: Perez
authors.affiliation: Department of Research, York Hospital, York, Pennsylvania.
authors.forename: Ted
authors.initials: T
authors.lastname: Bell
authors.affiliation: Department of Research, York Hospital, York, Pennsylvania.
authors.forename: Rod
authors.initials: R
authors.lastname: Grim
authors.affiliation: Department of Research, York Hospital, York, Pennsylvania.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Martin
authors.affiliation: Department of General Surgery, York Hospital, York, Pennsylvania.
authors.forename: Vanita
authors.initials: V
authors.lastname: Ahuja
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs; D006331:Heart Diseases / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology