Impact of Surgeon Experience and Centre Volume on Outcome After Off-Pump Coronary Artery Bypass Surgery: Results from the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) Registry
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Impact of Surgeon Experience and Centre Volume on Outcome After Off-Pump Coronary Artery Bypass Surgery: Results from the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) Registry. / Naito, Shiho; Demal, Till J; Sill, Björn; Reichenspurner, Hermann; Onorati, Francesco; Gatti, Giuseppe; Mariscalco, Giovanni; Faggian, Giuseppe; Salsano, Antonio; Santini, Francesco; Santarpino, Giuseppe; Zanobini, Marco; Musumeci, Francesco; Rubino, Antonino S; Bancone, Ciro; De Feo, Marisa; Nicolini, Francesco; Dalén, Magnus; Speziale, Giuseppe; Bounader, Karl; Mäkikallio, Timo; Tauriainen, Tuomas; Ruggieri, Vito G; Perrotti, Andrea; Biancari, Fausto.
in: HEART LUNG CIRC, Jahrgang 32, Nr. 3, 03.2023, S. 387-394.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Impact of Surgeon Experience and Centre Volume on Outcome After Off-Pump Coronary Artery Bypass Surgery: Results from the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) Registry
AU - Naito, Shiho
AU - Demal, Till J
AU - Sill, Björn
AU - Reichenspurner, Hermann
AU - Onorati, Francesco
AU - Gatti, Giuseppe
AU - Mariscalco, Giovanni
AU - Faggian, Giuseppe
AU - Salsano, Antonio
AU - Santini, Francesco
AU - Santarpino, Giuseppe
AU - Zanobini, Marco
AU - Musumeci, Francesco
AU - Rubino, Antonino S
AU - Bancone, Ciro
AU - De Feo, Marisa
AU - Nicolini, Francesco
AU - Dalén, Magnus
AU - Speziale, Giuseppe
AU - Bounader, Karl
AU - Mäkikallio, Timo
AU - Tauriainen, Tuomas
AU - Ruggieri, Vito G
AU - Perrotti, Andrea
AU - Biancari, Fausto
N1 - Copyright © 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
PY - 2023/3
Y1 - 2023/3
N2 - AIM: The aim of this study was to assess the impact of surgeon experience and centre volume on early operative outcomes in patients undergoing off-pump coronary artery bypass (OPCAB) surgery.METHOD: Of 7,352 patients in the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) registry, 1,549 underwent OPCAB and were included in the present analysis. Using adjusted regression analysis, we compared major early adverse events after procedures performed by experienced OPCAB surgeons (i.e., ≥20 cases per year; n=1,201) to those performed by non-OPCAB surgeons (n=348). Furthermore, the same end points were compared between procedures performed by OPCAB surgeons in high OPCAB volume centres (off-pump technique used in >50% of cases; n=894) and low OPCAB volume centres (n=307).RESULTS: In the experienced OPCAB surgeon group, we observed shorter procedure times (β -43.858, 95% confidence interval [CI] -53.322 to -34.393; p<0.001), a lower rate of conversion to cardiopulmonary bypass (odds ratio [OR] 0.284, 95% CI 0.147-0.551; p<0.001), a lower rate of prolonged inotrope or vasoconstrictor use (OR 0.492, 95% CI 0.371-0.653; p<0.001), a lower rate of early postprocedural percutaneous coronary interventions (OR 0.335, 95% CI 0.169-0.663; p=0.002), and lower 30-day mortality (OR 0.423, 95% CI 0.194-0.924; p=0.031). In high OPCAB volume centres, we found a lower rate of prolonged inotrope use (OR 0.584, 95% CI 0.419-0.814; p=0.002), a lower rate of postprocedural acute kidney injury (OR 0.382, 95% CI 0.198-0.738; p=0.004), shorter duration of intensive care unit (β -1.752, 95% CI -2.240 to -1.264; p<0.001) and hospital (β -1.967; 95% CI -2.717 to -1.216; p<0.001) stays, and lower 30-day mortality (OR 0.316, 95% CI 0.114-0.881; p=0.028).CONCLUSIONS: Surgeon experience and centre volume may play an important role on the early outcomes after OPCAB surgery.
AB - AIM: The aim of this study was to assess the impact of surgeon experience and centre volume on early operative outcomes in patients undergoing off-pump coronary artery bypass (OPCAB) surgery.METHOD: Of 7,352 patients in the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) registry, 1,549 underwent OPCAB and were included in the present analysis. Using adjusted regression analysis, we compared major early adverse events after procedures performed by experienced OPCAB surgeons (i.e., ≥20 cases per year; n=1,201) to those performed by non-OPCAB surgeons (n=348). Furthermore, the same end points were compared between procedures performed by OPCAB surgeons in high OPCAB volume centres (off-pump technique used in >50% of cases; n=894) and low OPCAB volume centres (n=307).RESULTS: In the experienced OPCAB surgeon group, we observed shorter procedure times (β -43.858, 95% confidence interval [CI] -53.322 to -34.393; p<0.001), a lower rate of conversion to cardiopulmonary bypass (odds ratio [OR] 0.284, 95% CI 0.147-0.551; p<0.001), a lower rate of prolonged inotrope or vasoconstrictor use (OR 0.492, 95% CI 0.371-0.653; p<0.001), a lower rate of early postprocedural percutaneous coronary interventions (OR 0.335, 95% CI 0.169-0.663; p=0.002), and lower 30-day mortality (OR 0.423, 95% CI 0.194-0.924; p=0.031). In high OPCAB volume centres, we found a lower rate of prolonged inotrope use (OR 0.584, 95% CI 0.419-0.814; p=0.002), a lower rate of postprocedural acute kidney injury (OR 0.382, 95% CI 0.198-0.738; p=0.004), shorter duration of intensive care unit (β -1.752, 95% CI -2.240 to -1.264; p<0.001) and hospital (β -1.967; 95% CI -2.717 to -1.216; p<0.001) stays, and lower 30-day mortality (OR 0.316, 95% CI 0.114-0.881; p=0.028).CONCLUSIONS: Surgeon experience and centre volume may play an important role on the early outcomes after OPCAB surgery.
U2 - 10.1016/j.hlc.2022.11.009
DO - 10.1016/j.hlc.2022.11.009
M3 - SCORING: Journal article
C2 - 36566143
VL - 32
SP - 387
EP - 394
JO - HEART LUNG CIRC
JF - HEART LUNG CIRC
SN - 1443-9506
IS - 3
ER -
