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Minimally Invasive vs Open Coronary Surgery: A Multi-Institutional Analysis of Cost and Outcomes
- Source :
- The Annals of Thoracic Surgery. 111:1478-1484
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background Limited multi-institutional data evaluating minimally invasive cardiac surgery (MICS) coronary artery bypass surgery (CABG) outcomes have raised concern for increased resource utilization compared with standard sternotomy. The purpose of this study was to assess short-term outcomes and resource utilization with MICS CABG in a propensity-matched regional cohort. Methods Isolated CABG patients (2012-2019) were extracted from a regional Society of Thoracic Surgeons database. Patients were stratified by MICS CABG vs open CABG via sternotomy, propensity-score matched 1:2 to balance baseline differences, and compared by univariate analysis. Results Of 26,255 isolated coronary artery bypass graft patients, 139 MICS CABG and 278 open CABG patients were well balanced after matching. There was no difference in the operative mortality rate (2.2% open vs 0.7% MICS CABG, P = .383) or major morbidity (7.9% open vs 7.2% MICS CABG, P = .795). However, open CABG patients received more blood products (22.2% vs 12.2%, P = .013), and had longer intensive care unit (45 vs 30 hours, P = .049) as well as hospital lengths of stay (7 vs 6 days, P = .005). Finally, median hospital cost was significantly higher in the open CABG group ($35,011 vs $27,906, P Conclusions Open CABG via sternotomy and MICS CABG approaches are associated with similar, excellent perioperative outcomes. However, MICS CABG was associated with fewer transfusions, shorter length of stay, and ∼$7000 lower hospital cost, a superior resource utilization profile that improves patient care and lowers cost.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Coronary surgery
Coronary Artery Disease
030204 cardiovascular system & hematology
law.invention
03 medical and health sciences
Coronary artery bypass surgery
0302 clinical medicine
law
Minimally invasive cardiac surgery
Humans
Minimally Invasive Surgical Procedures
Medicine
cardiovascular diseases
Coronary Artery Bypass
Aged
Retrospective Studies
Univariate analysis
business.industry
Perioperative
Middle Aged
Sternotomy
Intensive care unit
Surgery
Treatment Outcome
surgical procedures, operative
medicine.anatomical_structure
030228 respiratory system
Cohort
Costs and Cost Analysis
Female
Cardiology and Cardiovascular Medicine
business
Artery
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 111
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....5530dd06b7006e6f008565b9668e03c2