Propensity-score analysis of early outcomes after bilateral versus single internal thoracic artery grafting

Sorin V. Pusca, Patrick D. Kilgo, J. David Vega, William A. Cooper, Thomas A. Vassiliades, Edward P. Chen, Omar M. Lattouf, Robert A. Guyton, John D. Puskas

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

OBJECTIVE: The use of bilateral internal thoracic arteries (BITAs) during coronary artery bypass grafting (CABG) improves long-term and event-free survival compared with single internal thoracic artery (SITA) grafting. It is controversial whether BITA grafting alters in-hospital adverse events after CABG. METHODS: Isolated CABG cases using BITA or SITA at a single US academic center between January 1, 1997 and June 30, 2006 were retrospectively reviewed. A propensity score was used as a covariate to balance the treatment groups (BITA and SITA) with respect to 44 preoperative risk factors. A multivariable logistic regression model tested whether treatment type was significantly associated with in-hospital death, deep sternal wound infection (DSWI), or hospital length of stay (LOS). RESULTS: There were 599 BITA and 10,212 SITA cases performed. Overall for all BITA versus SITA cases, adjusted mortality (0.8% vs. 1.7%, P = 0.85) was not different between the groups. However, adjusted incidence of DSWI (2.0% vs. 1.2%, P = 0.036) and LOS (6.7 vs. 6.1, P = 0.025) were significantly higher in BITA patients. Subsets analyses of obese patients and diabetic patients revealed no statistical differences for any of the outcomes between BITA and SITA. CONCLUSIONS: The long-term benefits of BITA grafting do not come at the cost of increased adjusted risk of in-hospital death. BITA grafting was associated with an increased risk of DSWI and a longer adjusted LOS. Neither obesity, nor diabetes significantly increased the risk of poor outcomes after BITA.

Original languageEnglish
Pages (from-to)19-24
Number of pages6
JournalInnovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Volume3
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

Keywords

  • BITA
  • Multivariable logistic regression
  • Propensity score
  • SITA

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