Reduced 30-day mortality in men after elective coronary artery bypass surgery with minimized extracorporeal circulation-a propensity score analysis

BMC Cardiovascular Disorders

Claudius Diez¹  Christof Schmid¹  Michael Hilker¹  Andreas Keyser¹  Leopold Rupprecht¹  Reinhard Kobuch¹  Michael Ried¹ 

[1] Department of Cardiothoracic Surgery, University Medical Center Regensburg, Franz-Josef-Strauß-Allee 11, Regensburg 93053, Germany

关键词: Propensity score analysis;    Mortality;    CABG;    MECC;    Men;    Outcome;   

Others  :  1085217
DOI  :  10.1186/1471-2261-12-17

 received in 2011-10-22, accepted in 2012-03-16,  发布年份 2012

【 摘 要 】

Background

Impact of minimized extracorporeal circulation (MECC) for coronary surgery on mortality remains controversial and gender significantly influence outcome.

Methods

We analyzed 3,139 male patients undergoing elective coronary surgery between 01/2004 and 05/2009. Using propensity score matching after binary logistic regression, 1,005 patients (from 1,119 patients) undergoing surgery with MECC could be matched with 1,005 patients (from 2,020 patients) undergoing surgery with conventional extracorporeal circulation (CECC). Primary outcome was 30-day mortality.

Results

Unadjusted 30-day mortality was 2.7% in patients with CECC and 0.8% in those with MECC (mean difference -1.9%; p < 0.001). The adjusted mean difference (average treatment effect of the treated) after matching was -1.5% (95% confidence interval (CI) -2.6 to -0.4; p = 0.006). Postoperative hospital stay was shorter in patients operated with minimized systems (adjusted mean difference -0.8 days; 95% CI -1.46 to -0.09; p = 0.03) and incidence of postoperative neurocognitive dysfunction was also lower (adjusted mean difference -1.3%; 95% CI -2.2 to -0.4; p = 0.001). Chest tube drainage (adjusted mean difference +22 mL; 95% CI -47 to 91; p = 0.5) and risk for acute kidney injury, kidney injury and failure according to RIFLE criteria (adjusted mean difference -1.0%; 95% CI -2.5 to 0.6; p = 0.24) proved to be insignificant between both groups. Apart from reduced 30-day mortality, however, average treatment effects for intensive care unit stay, postoperative hospital stay, chest tube drainage and kidney injury did not significantly differ.

Conclusion

Using propensity score analysis, we observed an association between MECC and reduced 30-day mortality in men, but our results call for further analysis.

【 授权许可】

   
2012 Ried et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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