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ABSTRACT 47
WHAT IS THE IMPACT OF OFF-PUMP CORONARY ARTERY
BYPASS SURGERY ON CLINICAL OUTCOMES? A REPORT COMPARING HIGH
VOLUME PROGRAMS TO LOW VOLUME PROGRAMS.
Phillip Brown, Centennial Hospital, Nashville, TN; Sal
Battaglia, HCA Healthcare, Nashville, TN; Lynn Tarkington, HCA
Healthcare, Nashville, TN; Edmund Becker, Emory University, Atlanta,
GA; April Simon, Cardiac Data Solutions, Inc., Atlanta, GA
Purpose: The purpose of this study was to analyze clinical
outcomes at high versus low/no volume OPCAB programs.
Methods: The HCA Casemix database was utilized to examine the
clinical outcomes of 16,988 consecutive CABG patients at 72 facilities
in 1999. 14,950 of the procedures were performed at low/no OPCAB
volume facilities and 2,038 were performed at high volume OPCAB
facilities. High volume was defined as > 100/year.
There were a total of 2,379 OPCAB procedures performed at all
facilities.
Results: Statistically significant results are reported below.
| |
High Vol. OPCAB
|
Low/No Vol. OPCAB
|
P-Value
|
|
Cardiac Complications.
|
3.04%
|
7.47%
|
<0.001
|
|
Neuro Complications
|
0.83%
|
1.45%
|
0.025
|
|
Renal Complications
|
0.34%
|
0.97%
|
0.005
|
|
Respiratory Complications
|
1.22%
|
3.29%
|
<0.001
|
|
Shock/Hemorrhage
|
2.16%
|
3.79%
|
<0.001
|
Conclusion: While the mortality rate was not significantly different,
it does appear that complications are lower at high volume OPCAB
programs.
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