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Trends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017.
- Source :
-
Journal of the American Heart Association [J Am Heart Assoc] 2020 Oct 20; Vol. 9 (20), pp. e016980. Date of Electronic Publication: 2020 Oct 13. - Publication Year :
- 2020
-
Abstract
- Background The likelihood of undergoing reoperative coronary artery bypass graft surgery (CABG) is important for older patients who are considering first-time CABG. Trends in the reoperative CABG for these patients are unknown. Methods and Results We used the Medicare fee-for-service inpatient claims data of adults undergoing isolated first-time CABG between 1998 and 2017. The primary outcome was time to first reoperative CABG within 5 years of discharge from the index surgery, treating death as a competing risk. We fitted a Cox regression to model the likelihood of reoperative CABG as a function of patient baseline characteristics. There were 1 666 875 unique patients undergoing first-time isolated CABG and surviving to hospital discharge. The median (interquartile range) age of patients did not change significantly over time (from 74 [69-78] in 1998 to 73 [69-78] in 2017); the proportion of women decreased from 34.8% to 26.1%. The 5-year rate of reoperative CABG declined from 0.77% (95% CI, 0.72%-0.82%) in 1998 to 0.23% (95% CI, 0.19%-0.28%) in 2013. The annual proportional decline in the 5-year rate of reoperative CABG overall was 6.6% (95% CI, 6.0%-7.1%) nationwide, which did not differ across subgroups, except the non-white non-black race group that had an annual decline of 8.5% (95% CI, 6.2%-10.7%). Conclusions Over a recent 20-year period, the Medicare fee-for-service patients experienced a significant decline in the rate of reoperative CABG. In this cohort of older adults, the rate of declining differed across demographic subgroups.
- Subjects :
- Aged
Ethnicity statistics & numerical data
Female
Heart Disease Risk Factors
Humans
Likelihood Functions
Male
Medicare statistics & numerical data
Prognosis
United States epidemiology
Coronary Artery Bypass methods
Coronary Artery Bypass statistics & numerical data
Coronary Artery Disease epidemiology
Coronary Artery Disease surgery
Hospitalization statistics & numerical data
Long Term Adverse Effects epidemiology
Long Term Adverse Effects surgery
Reoperation methods
Reoperation trends
Subjects
Details
- Language :
- English
- ISSN :
- 2047-9980
- Volume :
- 9
- Issue :
- 20
- Database :
- MEDLINE
- Journal :
- Journal of the American Heart Association
- Publication Type :
- Academic Journal
- Accession number :
- 33045889
- Full Text :
- https://doi.org/10.1161/JAHA.120.016980