Off-pump CABG was associated with higher unadjusted mortality, longer length of stay, and increased sepsis, but lower stroke risk compared to on-pump CABG.
Observational
Yes
Does off-pump CABG improve in-hospital outcomes compared to on-pump CABG in patients with coronary artery disease?
Off-pump CABG is associated with higher unadjusted in-hospital mortality and sepsis but lower stroke risk compared to on-pump CABG, though confounding by patient risk factors is likely.
.Coronary artery bypass graft (CABG) surgery is the mainstay for surgical treatment of coronary artery disease. CABG is performed in one of two ways: (1) while the heart is temporarily arrested, and a patient receives cardiopulmonary bypass (‘on pump’); or (2) without cardiopulmonary bypass with the heart still beating (‘off pump’). This observational study using data from 2004-2015 from the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) examined trends in utilization and outcomes (in-hospital mortality, length of stay (LOS), hospital costs, and selected post-operative complications associated with on and off pump CABG. Overall, there was a declining trend in the number of CABG procedures. Off-pump procedure patients had significantly higher unadjusted mortality rates and longer LOS, but without significantly higher costs. There was a lower risk of post-operative stroke associated with off-pump procedures, but an increased occurrence of post-operative sepsis. One possible explanation is that more patients may be receiving angioplasty, which may have increased the pool of CABG patients with higher risk factors. Hospital administrators may use this information to optimize patient outcomes in cardiovascular surgery units. Future research should seek to control for patient level risk factors in the selection of surgical procedure.
Baumgardner et al. (Thu,) conducted a observational in Coronary artery disease. Off-pump coronary artery bypass graft surgery vs. On-pump coronary artery bypass graft surgery was evaluated on Trends in utilization, in-hospital mortality, length of stay, hospital costs, and selected post-operative complications. Off-pump CABG was associated with higher unadjusted mortality, longer length of stay, and increased sepsis, but lower stroke risk compared to on-pump CABG.