What question did this study set out to answer?

To evaluate how advanced age and surgical approach (with or without cardiopulmonary bypass) influence early and mid-term clinical outcomes in elderly patients undergoing coronary revascularization.

July 1, 2002European Journal of Cardio-Thoracic SurgeryOpen Access

Coronary artery bypass grafting in patients over 70 years old: the influence of age and surgical technique on early and mid-term clinical outcomes

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Why the study?

Does off-pump CABG improve early and mid-term mortality and morbidity compared to on-pump CABG in patients over 70 years old?

Population

990 patients older than 70 years undergoing coronary revascularisation

Comparison

Off-pump coronary artery bypass grafting vs On-pump coronary artery bypass grafting (CABG)

Design

Cohort

Follow-up

early and mid-term

Authors

RARaimondo AscioneCardiac Surgery

Discussion

Member takes

Implication

May reduce early complications in elderly patients; leaves open randomized confirmation of mid-term equivalence to on-pump CABG.

Key Points

To evaluate how advanced age and surgical approach (with or without cardiopulmonary bypass) influence early and mid-term clinical outcomes in elderly patients undergoing coronary revascularization.
Prospective cohort analysis of 990 patients aged 70 years or older extracted from a consecutive database of 3,842 patients undergoing coronary revascularization between April 1996 and December 2000.
Patients were stratified by age group (70–74 years [n=659] vs. ≥75 years [n=331]) and surgical method (off-pump [n=219] vs. on-pump cardiopulmonary bypass [n=771]).
Patients aged ≥75 years had significantly higher in-hospital mortality, re-intubation rates, renal dysfunction, and hospital stay durations compared to those aged 70–74 years, though mid-term mortality and cardiac events did not differ significantly.
After adjusting for prognostic baseline variables, off-pump bypass was associated with reduced inotropic drug use, intra-operative arrhythmias, blood loss, and transfusion requirements compared to on-pump bypass (ORs 0.26 to 0.87, all P<0.05).

Structured PICO

Does off-pump CABG improve early and mid-term mortality and morbidity compared to on-pump CABG in patients over 70 years old?

Population

990 patients older than 70 years undergoing coronary revascularisation (659 aged 70-74 years, 331 aged ≥75 years)

Intervention

Off-pump coronary artery bypass grafting (CABG) (n=219)

Comparator

On-pump coronary artery bypass grafting (CABG)

Outcome

Early and mid-term mortality and morbidityhard clinical

Off-pump CABG is safe and effective in elderly patients, reducing early perioperative complications like blood loss and arrhythmias without compromising mid-term mortality compared to on-pump CABG.

Cite This Study

Raimondo Ascione (2002) studied this question.

synapsesocial.com/papers/6a8929666abbd4965f28b537 https://doi.org/10.1016/s1010-7940(02)00243-9

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Coronary artery bypass grafting in patients over 70 years old: the influence of age and surgical technique on early and mid-term clinical outcomes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Coronary artery bypass grafting in patients over 70 years old: the influence of age and surgical technique on early and mid-term clinical outcomes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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