Key result
Short DAOH after off-pump CABG is linked to ~207% higher mortality.
Why the study?
Days alive and out of hospital (DAOH) had not been validated solely in off-pump coronary artery bypass grafting (OPCAB), leading this study to evaluate the correlation between DAOH and OPCAB outcomes.
Does short Days Alive and Out of Hospital (DAOH) at 30 days predict long-term mortality and MACCE in adult patients undergoing off-pump coronary artery bypass grafting?
Cohort (n=2,211)
No
Does short Days Alive and Out of Hospital (DAOH) at 30 days predict long-term mortality and MACCE in adult patients undergoing off-pump coronary artery bypass grafting?
Effect estimate: HR 3.07 (95% CI 1.45-6.52)
Absolute Event Rate: 5.7% vs 1.2%
p-value: p=0.004
Short days alive and out of hospital (DAOH) at 30 days is significantly associated with increased 3-year mortality and MACCE after off-pump coronary artery bypass grafting, suggesting it is a reliable and easily obtainable long-term outcome measure.
Short DAOH at 30 days may flag higher-risk off-pump CABG patients; leaves open its use for decisions or as a trial endpoint.
Days alive and out of hospital (DAOH) is a simple estimator based on the number of days not in hospital within a defined period. In cases of mortality within the period, DAOH is regarded as zero. It has not been validated solely in off-pump coronary artery bypass grafting (OPCAB). This study aimed to demonstrate a correlation between DAOH and outcome of OPCAB. We identified 2211 OPCAB performed from January 2010 to August 2016. We calculated DAOH at 30 and 60 days. We generated a receiver-operating curve and compared outcomes. The median duration of hospital stay after OPCAB was 6 days. The median DAOH values at 30 and 60 days were 24 and 54 days. The estimated thresholds for 3-year mortality for DAOH at 30 and 60 days were 20 and 50 days. Three-year mortality was higher for short DAOH (1.2% vs. 5.7% and 1.1% vs. 5.6% DAOH at 30 and 60 days). After adjustment, the short DAOH 30 group showed significantly higher mortality during 3-year follow-up (hazard ratio 3.07; 95% confidence interval 1.45-6.52; p = 0.004). DAOH at 30 days after OPCAB showed a correlation with 3-year outcomes. DAOH 30 might be a reliable long-term outcome measure that can be obtained within 30 days after surgery.
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Oh et al. (2023) conducted a cohort in Off-pump coronary artery bypass grafting (n=2,211). Short days alive and out of hospital at 30 days (≤ 20 days) vs. Long days alive and out of hospital at 30 days (> 20 days) was evaluated on 3-year mortality (HR 3.07, 95% CI 1.45-6.52, p=0.004). Short days alive and out of hospital (≤20 days) at 30 days after off-pump coronary artery bypass grafting was associated with higher 3-year mortality (HR 3.07) compared to longer DAOH.
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