Pubblicazioni

Autori:

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

Titolo:

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

Anno:

2022

Tipologia prodotto:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Lingua:

Inglese

Referee:

No

Nome rivista:

HEART LUNG & CIRCULATION

ISSN Rivista:

1443-9506

Intervallo pagine:

1-8

Parole chiave:

Centre volume; Individual surgeon; Off-pump coronary bypass; Surgeon volume

Breve descrizione dei contenuti:

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.

Id prodotto:

131786

Handle IRIS:

11562/1085454

ultima modifica:

23 febbraio 2023

Citazione bibliografica:

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, 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 «HEART LUNG & CIRCULATION» , 2022 , pp. 1-8

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