Off-pump surgery decreases postoperative complications and resource utilization in the elderly

Walter D Boyd, Nimesh D. Desai, Dario F. Del Rizzo, Richard J. Novick, F. Neil McKenzie, Alan H. Menkis

Research output: Contribution to journalArticle

165 Citations (Scopus)

Abstract

Background. Bypass surgery in the elderly (age >70 years) has increased mortality and morbidity, which may be a consequence of cardiopulmonary bypass. We compare the outcomes of a cohort of elderly off-pump coronary artery bypass (OPCAB) patients with elderly conventional coronary artery bypass grafting (CABG) patients. Methods. Chart and provincial cardiac care registry data were reviewed for 30 consecutive elderly OPCAB patients (age 74.7 ± 4.2 years) and 60 consecutive CABG patients (age 74.9 ± 4.1 years, p = 0.82) with similar risk factor profiles: Parsonnet score 17.2 ± 8.1 (OPCAB) versus 15.6 ± 6.5 (CABG), p = 0.31; and Ontario provincial acuity index 4.5 ± 1.9 (OPCAB) versus 4.3 ± 2.0 (CABG), p = 0.65. Results. Mean hospital stay was 6.3 ± 1.8 days for OPCAB patients and 7.7 ± 3.9 days for CABG patients (p < 0.05). Average intensive care unit stay was 24.0 ± 10.9 h for OPCAB patients versus 36.6 ± 33.5 h for CABG patients (p < 0.05). Atrial fibrillation occurred in 10.0% of OPCAB patients and 28.3% of CABG patients (p < 0.05). Low output syndrome was observed in 10% of OPCAB patients and 31.7% of CABG patients (p < 0.05). Cost was reduced by $1,082 (Canadian) per patient in the OPCAB group. Postoperative OPCAB graft analysis showed 100% patency. Conclusions. OPCPAB is safe in the geriatric population and significantly reduces postoperative morbidity and cost.

Original languageEnglish (US)
Pages (from-to)1490-1493
Number of pages4
JournalAnnals of Thoracic Surgery
Volume68
Issue number4
DOIs
StatePublished - Oct 1999
Externally publishedYes

Fingerprint

Off-Pump Coronary Artery Bypass
Coronary Artery Bypass
Morbidity
Costs and Cost Analysis
Ontario
Cardiopulmonary Bypass
Geriatrics
Atrial Fibrillation
Intensive Care Units
Registries
Length of Stay

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Boyd, W. D., Desai, N. D., Del Rizzo, D. F., Novick, R. J., McKenzie, F. N., & Menkis, A. H. (1999). Off-pump surgery decreases postoperative complications and resource utilization in the elderly. Annals of Thoracic Surgery, 68(4), 1490-1493. https://doi.org/10.1016/S0003-4975(99)00951-0

Off-pump surgery decreases postoperative complications and resource utilization in the elderly. / Boyd, Walter D; Desai, Nimesh D.; Del Rizzo, Dario F.; Novick, Richard J.; McKenzie, F. Neil; Menkis, Alan H.

In: Annals of Thoracic Surgery, Vol. 68, No. 4, 10.1999, p. 1490-1493.

Research output: Contribution to journalArticle

Boyd, WD, Desai, ND, Del Rizzo, DF, Novick, RJ, McKenzie, FN & Menkis, AH 1999, 'Off-pump surgery decreases postoperative complications and resource utilization in the elderly', Annals of Thoracic Surgery, vol. 68, no. 4, pp. 1490-1493. https://doi.org/10.1016/S0003-4975(99)00951-0
Boyd, Walter D ; Desai, Nimesh D. ; Del Rizzo, Dario F. ; Novick, Richard J. ; McKenzie, F. Neil ; Menkis, Alan H. / Off-pump surgery decreases postoperative complications and resource utilization in the elderly. In: Annals of Thoracic Surgery. 1999 ; Vol. 68, No. 4. pp. 1490-1493.
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abstract = "Background. Bypass surgery in the elderly (age >70 years) has increased mortality and morbidity, which may be a consequence of cardiopulmonary bypass. We compare the outcomes of a cohort of elderly off-pump coronary artery bypass (OPCAB) patients with elderly conventional coronary artery bypass grafting (CABG) patients. Methods. Chart and provincial cardiac care registry data were reviewed for 30 consecutive elderly OPCAB patients (age 74.7 ± 4.2 years) and 60 consecutive CABG patients (age 74.9 ± 4.1 years, p = 0.82) with similar risk factor profiles: Parsonnet score 17.2 ± 8.1 (OPCAB) versus 15.6 ± 6.5 (CABG), p = 0.31; and Ontario provincial acuity index 4.5 ± 1.9 (OPCAB) versus 4.3 ± 2.0 (CABG), p = 0.65. Results. Mean hospital stay was 6.3 ± 1.8 days for OPCAB patients and 7.7 ± 3.9 days for CABG patients (p < 0.05). Average intensive care unit stay was 24.0 ± 10.9 h for OPCAB patients versus 36.6 ± 33.5 h for CABG patients (p < 0.05). Atrial fibrillation occurred in 10.0{\%} of OPCAB patients and 28.3{\%} of CABG patients (p < 0.05). Low output syndrome was observed in 10{\%} of OPCAB patients and 31.7{\%} of CABG patients (p < 0.05). Cost was reduced by $1,082 (Canadian) per patient in the OPCAB group. Postoperative OPCAB graft analysis showed 100{\%} patency. Conclusions. OPCPAB is safe in the geriatric population and significantly reduces postoperative morbidity and cost.",
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