Prophylactic value of preincision intra-aortic balloon pump: analysis of a statewide experienceQuantitative Health Sciences Publications and Presentations
UMMS AffiliationDepartment of Quantitative Health Sciences
SubjectsAged; Alabama; Analysis of Variance; Comorbidity; *Coronary Artery Bypass; Coronary Disease; Female; Follow-Up Studies; Hemodynamics; Humans; *Intra-Aortic Balloon Pumping; data; Intraoperative Care; Length of Stay; Logistic Models; Male; *Patient Selection; Postoperative Complications; Proportional Hazards Models; Risk Factors; Survival Analysis; Time Factors; Treatment Outcome
AbstractOBJECTIVE: The objective of this study was to determine whether preincision use of an intra-aortic balloon pump improves survival and shortens postoperative length of stay in hemodynamically stable, high-risk patients undergoing coronary artery bypass grafting. METHODS: A post hoc analysis of the Alabama CABG Cooperative Project database was performed by using propensity scores to model the likelihood of receiving a prophylactic preincision intra-aortic balloon pump. Every patient receiving a prophylactic preincision balloon pump was matched with another patient of similar propensity score who did not receive one. We then compared outcomes for matched pairs. RESULTS: There were 7581 patients of whom 592 received a prophylactic preincision balloon pump. Patients with preoperative renal insufficiency, heart failure, or left main coronary artery disease, or who had undergone previous bypass grafting were significantly more likely to receive a prophylactic preincision balloon pump. By using propensity scores, we matched 550 patients who received a prophylactic preincision balloon pump with 550 who did not. Survival did not significantly differ by whether a prophylactic preincision balloon pump was used. However, surviving patients who received a preincision balloon pump had a significantly shorter postbypass length of stay (7 +/- 7.3 days) than did matched patients not receiving a balloon pump (8 +/- 6.2 days; P <.05). CONCLUSIONS: No survival advantage was found for use of a prophylactic intra-aortic balloon pump in hemodynamically stable, high-risk patients undergoing bypass grafting, as opposed to placing a balloon pump on an "as needed" basis during or after the operation. However, the patients receiving the balloon pump had improved convalescence as shown by significantly shorter length of stay.
SourceJ Thorac Cardiovasc Surg. 2000 Dec;120(6):1112-9.
Related ResourcesLink to Article in PubMed
Citation InformationWilliam L. Holman, Qing Li, Catarina I. Kiefe, David C. McGiffin, et al.. "Prophylactic value of preincision intra-aortic balloon pump: analysis of a statewide experience" Vol. 120 Iss. 6 (2000) ISSN: 0022-5223 (Linking)
Available at: http://works.bepress.com/catarina_kiefe/166/