Does off-pump coronary artery bypass reduce mortality, morbidity, and resource utilization when compared with conventional coronary artery bypass? A meta-analysis of randomized trials.

摘要: The authors undertook a meta-analysis of 37 randomized trials (3369 patients) off-pump coronary artery bypass surgery versus conventional surgery. No significant differences were found for 30-day mortality (odds ratio [OR], 1.02; 95% confidence interval [CI], 0.58-1.80), myocardial infarction (OR, 0.77; 95%CI, 0.48-1.26), stroke 0.68; 0.33-1.40), renal dysfunction, intraaortic balloon pump, wound infection, rethoracotomy, or reintervention. However, significantly decreased atrial fibrillation 0.58; 0.44-0.77), transfusion 0.43; 0.29-0.65), inotrope requirements 0.48; 0.32-0.73), respiratory infections 0.41; 0.23-0.74), ventilation time (weighted mean difference, -3.4 h; -5.1 to -1.7 h), intensive care unit stay -0.3 days; 95%CI -0.6 -0.1 days), and hospital -1.0 -1.5 -0.5 days). Patency neurocognitive function results inconclusive. In-hospital 1-yr direct costs generally higher Therefore, this demonstrates that mortality, stroke, infarction, failure not reduced in surgery; however, selected short-term mid-term clinical resource outcomes improved compared with