Document Detail


Outcomes experience with off-pump coronary artery bypass surgery in women.
MedLine Citation:
PMID:  12643404     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It has been well documented that women have higher morbidity and mortality rates than men following coronary artery bypass graft (CABG) surgery. In view of this evidence, we investigated the following question: compared with on-pump CABG surgery, is there benefit to off-pump CABG surgery in women? METHODS: Our investigation analyzes patient mortality and 13 procedure complications controlling for 35 variables representing patient characteristics and comorbid conditions, and for procedure characteristics for a population of 16,871 consecutive women undergoing off-pump and on-pump CABG surgery at 78 hospitals for the period January 1998 to June 2001. RESULTS: Mean comparisons reveal that the mortality rate for women undergoing off-pump CABG surgery is nearly a percentage point lower than for women undergoing on-pump surgery (3.12 vs 3.90; p = 0.052). The complication rates for all complications analyzed (shock/hemorrhage, neurologic, cardiac, respiratory, renal, acute renal failure, adult respiratory distress syndrome, implant infection, postoperative infection, septicemia, pneumonia, and peripheral vascular) were lower for women off-pump than women on-pump with the exception of mechanical complications. Logistic regression results reveal, after controlling for 35 relevant patient characteristics, comorbid conditions and procedure characteristics, that women undergoing on-pump CABG surgery experience a 42% higher mortality rate (p = 0.0239) than women undergoing off-pump CABG surgery. CONCLUSIONS: Evidence suggests that off-pump CABG surgery may be better for women than on-pump CABG surgery because it appears to reduce mortality and respiratory complications, shorten lengths-of-stay, and increases discharges directly home. None of the 12 other complications investigated demonstrated an advantage for women undergoing on-pump surgery relative to those receiving off-pump surgery.
Authors:
Phillip P Brown; Michael J Mack; April W Simon; Salvatore Battaglia; Lynn Tarkington; Steve Horner; Steven D Culler; Edmund R Becker
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  74     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2003-03-19     Completed Date:  2003-04-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2113-9; discussion 2120     Citation Subset:  AIM; IM    
Affiliation:
HCA, Inc, Nashville, Tennesee, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiopulmonary Bypass
Comorbidity
Coronary Artery Bypass / methods*,  mortality*
Female
Humans
Postoperative Complications
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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