Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
SAFETY AND COST-EFFECTIVENESS OF MIDCABG IN HIGH-RISK CABG PATIENTS
Autore:
DELRIZZO DF; BOYD WD; NOVICK RJ; MCKENZIE FN; DESAI ND; MENKIS AH;
Indirizzi:
UNIV MANITOBA,HLTH SCI CTR,820 SHERBROOK ST,SUITE GH-604 WINNIPEG MB R3A 1R9 CANADA UNIV WESTERN ONTARIO,LONDON HLTH SCI CTR LONDON ON CANADA
Titolo Testata:
The Annals of thoracic surgery
fascicolo: 3, volume: 66, anno: 1998,
pagine: 1002 - 1007
SICI:
0003-4975(1998)66:3<1002:SACOMI>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
MYOCARDIAL REVASCULARIZATION; CARDIOPULMONARY BYPASS; CORONARY; MORTALITY; SURGERY; DISEASE; TRENDS; HEART; GRAFT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
18
Recensione:
Indirizzi per estratti:
Citazione:
D.F. Delrizzo et al., "SAFETY AND COST-EFFECTIVENESS OF MIDCABG IN HIGH-RISK CABG PATIENTS", The Annals of thoracic surgery, 66(3), 1998, pp. 1002-1007

Abstract

Background. Myocardial revascularization without cardiopulmonary bypass has been proposed as a potential therapeutic alternative in high-risk patients undergoing coronary artery bypass grafting. To evaluate this possibility we compared 15 high-risk (HX) patients in whom minimally invasive direct coronary artery bypass grafting was used as the method of revascularization with 41 consecutive patients who underwent conventional coronary artery bypass grafting during 1 month. Methods. Patients undergoing myocardial revascularization without cardiopulmonary bypass were significantly older than their low-risk (LR) counterparts (72.2 +/- 11.6 versus 63.3 +/- 9.7 years, p = 0.006). The demographic profile for PIX versus LR patients was as follows: female patients, 60.0% versus 26.8%, p = 0.02; diabetes, 20.0% versus 24.4%, p = 0.7; prior stroke, 33.3% versus 7.4%, p = 0.03; chronic obstructive pulmonary disease, 60.0% versus 9.8%, p < 0.0001; peripheral vascular disease, 33.3% versus 12.2%, p = 0.03, congestive heart failure, 26.6% versus 9.8%, p = 0.09; impaired left ventricular (ejection fraction < 0.40), 40.0% versus 17.0%, p = 0.07; urgent operation, 86.6% versus 46.3%, p < 0.0001; and redo operation, 20.0% versus 0%, p = 0.003. Results. Therewere no deaths in the HR group and one death in the LR group. The average intensive care unit stay was 1.1 +/- 0.5 days in HX patients versus 1.6 +/- 1.6 days in LR individuals (p = 0.2), and the average hospital stay was 6.1 +/- 1.8 versus 7.3 +/- 4.4 days, respectively (p 0.3). We used an acuity risk score index developed by the Adult Cardiac Care Network of Ontario to predict outcome in the HX group. The expectedintensive care unit stay in HR patients was 4.1 +/- 1.2 days (versus the observed stay of 1.1 +/-: 0.5 days, p < 0.0001), and the expected hospital stay was 12.5 +/-: 1.5 days (versus the observed stay of 6.1 /- 1.8 days, p < 0.0001). The expected mortality in the HR group was 6.1% versus 0%, p = 0.3. A cost regression model was used to examine predicted versus actual cost (in Canadian dollars) for the HR patient cohort (based on Ontario Ministry of Health funding). The expected costfor the HR cohort would have been $11,997 per patient. In contrast, the average cost for these 15 patients was $5,997 per patient, an estimated cost saving of 50%. Conclusions. Myocardial revascularization without cardiopulmonary bypass appears to be a safe and cost-effective therapeutic modality for HR patients requiring myocardial revascularization.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/09/20 alle ore 10:42:31