Ried, Michael and Haneya, Assad and Kolat, Philipp and Philipp, Alois and Kobuch, Reinhard and Hilker, Michael and Schmid, Christof and Diez, Claudius (2013) Emergency coronary artery bypass grafting using minimized versus standard extracorporeal circulation - a propensity score analysis. JOURNAL OF CARDIOTHORACIC SURGERY, 8: 59. ISSN 1749-8090,
Full text not available from this repository. (Request a copy)Abstract
Background: The impact of minimized extracorporeal circulation (MECC) for emergency revascularization remains controversial. Methods: A total of 348 patients underwent emergency CABG with MECC (n=146) or conventional extracorporeal circulation (CECC; n=175) between January 2005 and December 2010. Using propensity score matching after binary logistic regression, 100 patients, who underwent CABG with MECC could be matched with 100 patients, who underwent CABG with CECC. Primary outcome was 30-day mortality. Results: Unadjusted 30-day mortality was 14.8% in patients with CECC and 6.9% in those with MECC (mean difference -7.9%; p=0.03). The adjusted mean difference (average treatment effect of the treated, ATT) after matching was -1.0% (95% CI -8.6 to 7.6; p=1.0). Intensive care unit stay (adjusted mean difference 1.0; 95% CI -0.2 to 3.2; p=0.70) and hospital stay (adjusted mean difference 1.0; 95% CI -2.0 to 3.6; p=0.40) did not show significant differences between both groups. The adjusted mean difference for postoperative low cardiac output syndrome was -1.1% (95% CI -7.3 to 7.1; p=0.83) without significant differences between CECC and MECC. Postoperative mechanical ventilation time, drain loss, postoperative rethoracotomy, postoperative neurological events, new onset renal replacement therapy and respiratory failure also had insignificant average treatment effects of the treated. In addition, all average treatment effects (ATEs) did not significantly differ between both groups. Conclusion: Using propensity score estimation and matching, we did not observe significant differences in terms of survival and further outcomes in patients who undergo emergency CABG with CECC or MECC, but our results call for further analysis.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACUTE MYOCARDIAL-INFARCTION; CARDIOPULMONARY BYPASS; SURGERY; REVASCULARIZATION; SYSTEM; INTERVENTION; EUROSCORE; PUMP; Coronary artery bypass surgery; Minimized extracorporeal circulation; Emergency revascularization; Mortality; Propensity score analysis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 17 Apr 2020 06:55 |
| Last Modified: | 17 Apr 2020 06:55 |
| URI: | https://pred.uni-regensburg.de/id/eprint/16841 |
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