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Trends in Utilization and Safety of In-Hospital Coronary Artery Bypass Grafting During a Non-ST-Segment Elevation Myocardial Infarction.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2020 Nov 01; Vol. 134, pp. 32-40. Date of Electronic Publication: 2020 Aug 15. - Publication Year :
- 2020
-
Abstract
- Up to 10% of non-ST-segment elevation myocardial infarction (NSTEMI) patients require coronary artery bypass graft (CABG) surgery during their hospitalization. Contemporary, real-world, data regarding CABG utilization and safety in NSTEMI patients are lacking. Our objectives were to investigate the contemporary trends in utilization and outcomes of CABG in patients admitted for NSTEMI. Using the 2003 to 2015 National Inpatient Sample data, we identified hospitalizations for NSTEMI, during which a CABG was performed. Patients' sociodemographic and clinical characteristics, incidence of surgical complications, length of stay, and mortality were analyzed. Multivariate analyses were performed to identify predictors of in-hospital complications and mortality. An estimated total of 440,371 CABG surgeries, during a hospitalization for NSTEMI, were analyzed. The utilization of CABG was steady over the years. The data show increasing prevalence of individual co-morbidities as well as cases with Deyo Co-morbidity Index ≥2 (p <0.001). High, 26.4%, complication rate was driven mainly by cardiac and pulmonary complications. The mortality rate declined from 3.6% in 2003 to an average of 2.4% during 2010 to 2015. Older age, female gender, heart failure, and delayed CABG timing were independent predictors of adverse outcomes. In conclusion, utilization of in-hospital CABG as the primary revascularization strategy in patients with NSTEMI remained steady over the years. These data reveal the raising prevalence of co-morbidities during the study. High complication rate was recorded; however, the mortality declined over the years to about 2.4%. Delaying CABG was associated with small but statistically significant worsening in outcomes.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Comorbidity
Diabetes Mellitus epidemiology
Female
Heart Failure epidemiology
Hospitalization
Humans
Hypertension epidemiology
Incidence
Kidney Failure, Chronic epidemiology
Male
Middle Aged
Multivariate Analysis
Pulmonary Disease, Chronic Obstructive epidemiology
Risk Factors
Time-to-Treatment trends
United States epidemiology
Young Adult
Coronary Artery Bypass trends
Hospital Mortality trends
Length of Stay trends
Non-ST Elevated Myocardial Infarction surgery
Postoperative Complications epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 134
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 32919619
- Full Text :
- https://doi.org/10.1016/j.amjcard.2020.08.019