Predictors and In-Hospital Outcomes Among Patients Using a Single Versus Bilateral Mammary Arteries in Coronary Artery Bypass Grafting.
Age Distribution
Aged
Coronary Artery Bypass
/ methods
Coronary Artery Disease
/ surgery
Female
Hospital Costs
/ statistics & numerical data
Hospital Mortality
Hospitals, Rural
/ statistics & numerical data
Hospitals, Teaching
/ statistics & numerical data
Hospitals, Urban
/ statistics & numerical data
Humans
Length of Stay
/ statistics & numerical data
Male
Mammary Arteries
/ transplantation
Mediastinitis
/ epidemiology
Middle Aged
Postoperative Complications
/ epidemiology
Respiration, Artificial
/ statistics & numerical data
Sex Distribution
Stroke
/ epidemiology
Surgical Wound Infection
/ epidemiology
United States
/ epidemiology
Journal
The American journal of cardiology
ISSN: 1879-1913
Titre abrégé: Am J Cardiol
Pays: United States
ID NLM: 0207277
Informations de publication
Date de publication:
01 11 2020
01 11 2020
Historique:
received:
04
05
2020
revised:
02
08
2020
accepted:
04
08
2020
pubmed:
10
9
2020
medline:
1
12
2020
entrez:
9
9
2020
Statut:
ppublish
Résumé
The benefit of bilateral mammary artery (BIMA) use during coronary artery bypass grafting (CABG) continues to be debated. This study examined nationwide trends in BIMA use and factors influencing its utilization. Using the National Inpatient Sample, adults undergoing isolated multivessel CABG between 2005 and 2015 were identified and stratified based on the use of a single mammary artery or BIMA. Regression models were fit to identify patient and hospital level predictors of BIMA use and characterize the association of BIMA on outcomes including sternal infection, mortality, and resource utilization. An estimated 4.5% (n = 60,698) of patients underwent CABG with BIMA, with a steady increase from 3.8% to 5.0% over time (p<0.001). Younger age, male gender, and elective admission, were significant predictors of BIMA use. Moreover, private insurance was associated with higher odds of BIMA use (adjusted odds ratio 1.24) compared with Medicare. BIMA use was not a predictor of postoperative sternal infection, in-hospital mortality, or hospitalization costs. Overall, BIMA use remains uncommon in the United States despite no significant differences in acute postoperative outcomes. Several patient, hospital, and socioeconomic factors appear to be associated with BIMA utilization.
Identifiants
pubmed: 32900469
pii: S0002-9149(20)30854-7
doi: 10.1016/j.amjcard.2020.08.011
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
41-47Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.