Evidence map›Paper›PMID 30341680›Full record

ArticleGeneral thoracic and cardiovascular surgery2019

Off-pump coronary artery bypass in octogenarians: results of a statewide, matched comparison.

Alejandro Suarez-Pierre, Todd C Crawford, Charles D Fraser, Xun Zhou, Cecillia Lui, Bradley Taylor, Kurt Wehberg, John V Conte, Glenn J Whitman, Rawn Salenger and 1 more

Abstract read
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In one paragraph

Article in General thoracic and cardiovascular surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Alejandro Suarez-PierreDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Blalock Bldg. 1206, Baltimore, MD, 21287, USA. asuarez8@jhmi.edu.ORCID http://orcid.org/0000-0003-1821-6240
Todd C CrawfordDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Blalock Bldg. 1206, Baltimore, MD, 21287, USA.
Charles D FraserDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Blalock Bldg. 1206, Baltimore, MD, 21287, USA.
Xun ZhouDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Blalock Bldg. 1206, Baltimore, MD, 21287, USA.
Cecillia LuiDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Blalock Bldg. 1206, Baltimore, MD, 21287, USA.
Bradley TaylorDivision of Cardiac Surgery, University of Maryland Heart Center, Baltimore, MD, USA.
Kurt WehbergDivision of Cardiac Surgery, Peninsula Regional Medical Center, Salisbury, MD, USA.
John V ConteDivision of Cardiac Surgery, Penn State College of Medicine, Hershey, PA, USA.
Glenn J WhitmanDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Blalock Bldg. 1206, Baltimore, MD, 21287, USA.
Rawn SalengerDivision of Cardiac Surgery, University of Maryland St. Joseph Medical Center, Baltimore, MD, USA.
MCSQI Collaborative
Johns Hopkins University · USUniversity of Maryland, Baltimore · USPeninsula Regional Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesOff-pump coronary artery bypass grafting (OPCAB) may have advantages in the elderly. Although proven safe, it remains unclear whether OPCAB provides a short-term survival benefit in octogenarians. We sought to compare outcomes using propensity matching between OPCAB and conventional surgery in a statewide database.

methodsWe identified all octogenarians (≥ 80 years) who underwent isolated coronary artery bypass grafting (CAB) at 10 different centers in the state of Maryland from July 2011 to June 2016. We separated patients into two groups: OPCAB and on-pump coronary artery bypass (ONCAB). Patients were assigned propensity scores with a semi-parsimonious logistic regression model and matched 1:1 by the nearest-neighbor principle. A revascularization ratio was determined between the number of distal grafts sewn and number of diseased coronaries (≥ 50% stenosis).

resultsIn total, 926 octogenarians underwent isolated CAB (8.2% of all CAB): 798 (86%) had ONCAB and 128 (14%) had OPCAB. Propensity matching yielded 128 well-matched pairs. Operative mortality was similar between groups (OPCAB 5.5% vs ONCAB 3.1%, p = 0.364). Rates of complications were similar between groups. OPCAB patients had a lower revascularization ratio (0.92 vs 1.15, p < 0.001), but more frequent use of left internal mammary artery (97 vs 89%, p = 0.017), and decreased intraoperative transfusion rates (33 vs 63%, p < 0.001).

conclusionsIn comparing outcomes among octogenarians across the state of Maryland, OPCAB and ONCAB had similar mortality and morbidity. However, OPCAB was associated with a lower revascularization ratio. Thus, our results demonstrate no short-term survival benefit of OPCAB over ONCAB in octogenarians.

Indexed as

Coronary Artery Bypass, Off-PumpAged, 80 and overCoronary Artery BypassCoronary Artery DiseaseDatabases, FactualFemaleHospital MortalityHumansLogistic ModelsMalePostoperative ComplicationsPropensity ScoreTreatment OutcomeCoronary artery bypassOctogenariansOff pumpPropensity matching

Identifiers

PMID30341680
OpenAlexW2896880097

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.