Premium
Outcomes of robotic coronary artery bypass versus nonrobotic coronary artery bypass
Author(s) -
Yokoyama Yujiro,
Kuno Toshiki,
Malik Aaqib,
Briasoulis Alexandros
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15710
Subject(s) - medicine , propensity score matching , artery , coronary artery disease , mortality rate , coronary artery bypass surgery , cardiology , surgery
Background Robotic coronary artery bypass graft (CABG) has developed in recent decades, however, prior studies showed conflicting result of robotic CABG compared to nonrobotic CABG in terms of mortality, morbidity, and cost. Herein, we sought to analyze the in‐hospital outcomes and health care utilization after robotic CABG compared to nonrobotic CABG, based on data from a nationally representative sample. Methods Patients who underwent CABG were identified using the national inpatient sample. Endpoints were in‐hospital outcomes, length of stay, and total cost. Procedure‐related complications were identified via international classification of diseases (ICD)‐9 and ICD‐10 coding and propensity score matching analysis was performed. Results A total of 1,204,125 weighted adults underwent nonrobotic CABG and 7355 underwent robotic CABG in the United States between 2012 and 2017. The comparison of 7330 pairs after propensity score matching showed that in‐hospital mortality was higher for those who underwent nonrobotic CABG compared to those who underwent robotic CABG (2.1% vs. 1.1%, p = .029). Similarly, the rates of acute kidney injury, transfusion, postoperative hemorrhage, length of stay, and total cost were higher for nonrobotic CABG compared to robotic CABG (all p < .05). The proportions of routine discharges with (34.5% vs. 40.0%) or without (39.7% vs. 45.0%) home health care were higher among those who underwent robotic, whereas the proportion of transfer to skilled nursing facility/nursing home was more frequent for cases of nonrobotic CABG (22.4% vs. 13.4%). Conclusion Robotic CABG was associated with lower rates of in‐hospital mortality, acute kidney injury, transfusion, postoperative hemorrhage, total cost, and shorter hospital stay compared to nonrobotic CABG.