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Propensity-score analysis of early outcomes after bilateral versus single internal thoracic artery grafting.
MedLine Citation:
PMID:  22436718     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: : The use of bilateral internal thoracic arteries (BITAs) during coronary artery bypass grafting (CABG) improves long-term and event-free survival compared with single internal thoracic artery (SITA) grafting. It is controversial whether BITA grafting alters in-hospital adverse events after CABG.
METHODS: : Isolated CABG cases using BITA or SITA at a single US academic center between January 1, 1997 and June 30, 2006 were retrospectively reviewed. A propensity score was used as a covariate to balance the treatment groups (BITA and SITA) with respect to 44 preoperative risk factors. A multivariable logistic regression model tested whether treatment type was significantly associated with in-hospital death, deep sternal wound infection (DSWI), or hospital length of stay (LOS).
RESULTS: : There were 599 BITA and 10,212 SITA cases performed. Overall for all BITA versus SITA cases, adjusted mortality (0.8% vs. 1.7%, P = 0.85) was not different between the groups. However, adjusted incidence of DSWI (2.0% vs. 1.2%, P = 0.036) and LOS (6.7 vs. 6.1, P = 0.025) were significantly higher in BITA patients. Subsets analyses of obese patients and diabetic patients revealed no statistical differences for any of the outcomes between BITA and SITA.
CONCLUSIONS: : The long-term benefits of BITA grafting do not come at the cost of increased adjusted risk of in-hospital death. BITA grafting was associated with an increased risk of DSWI and a longer adjusted LOS. Neither obesity, nor diabetes significantly increased the risk of poor outcomes after BITA.
Authors:
Sorin V Pusca; Patrick D Kilgo; J David Vega; William A Cooper; Thomas A Vassiliades; Edward P Chen; Omar M Lattouf; Robert A Guyton; John D Puskas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Innovations (Philadelphia, Pa.)     Volume:  3     ISSN:  1556-9845     ISO Abbreviation:  Innovations (Phila)     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2012-03-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101257528     Medline TA:  Innovations (Phila)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  19-24     Citation Subset:  -    
Affiliation:
From the *Clinical Research Unit, Division of Cardiothoracic Surgery, Emory University School of Medicine; and †Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia.
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