BACKGROUND AND AIM: We have shown that cumulative sum (CUSUM) failure analysis may be more sensitive than standard statistical methods in detecting a cluster of adverse @entity1 outcomes after cardiac surgical procedures. We therefore applied CUSUM, as well as standard statistical techniques, to analyze a surgeon's experience with @entity453 ( @entity453 ) and on-pump procedures to determine whether the two techniques have similar or different outcomes. METHODS: In 320 @entity1 undergoing nonemergent, first time coronary artery bypass grafting, preoperative @entity1 characteristics, rates of mortality and major complications, and ICU and hospital lengths of stay were compared between the on-pump and @entity453 cohorts using Fisher's exact tests and Wilcoxon two sample tests. Predicted mortality and length of stay were determined using previously validated models of the Cardiac Care Network of Ontario. Observed versus expected ratios of both variables were calculated for the two types of procedures. Furthermore, CUSUM curves were constructed for the on-pump and @entity453 cohorts. A multivariable analysis of the predictors of hospital length of stay was also performed to determine whether the type of coronary artery bypass procedure had an independent impact on this variable. RESULTS: The predicted mortality risk and predicted hospital length of stay were almost identical in the 208 on-pump @entity1 (2.2 +/- 3.9%; 8.2 +/- 2.5 days) and the 112 @entity453 @entity1 (2.0 +/- 2.2%; 7.8 +/- 2.1 days). The incidence of hospital mortality and @entity64 were 2.9% and 2.4% in on-pump @entity1 versus zero in @entity453 @entity1 (p = 0.09 and 0.17, respectively). Mechanical ventilation for greater than 48 hours was significantly less common in @entity453 (1.8%) than in on-pump @entity1 (7.7%, p = 0.04). The rate of 10 major complications was 14.9% in on-pump versus 8.0% in @entity453 @entity1 (p = 0.08). @entity453 @entity1 experienced a hospital length of stay that was a median of 1.0 day shorter than on-pump @entity1 (p = 0.01). The observed versus expected ratio for length of stay was 0.78 in @entity453 @entity1 versus 0.95 in on-pump @entity1 . On CUSUM analysis, the failure curve in @entity453 @entity1 was negative and was flatter than that of on-pump @entity1 throughout the duration of the study. Furthermore, @entity453 was an independent predictor of a reduced hospital length of stay on multivariable analysis. CONCLUSIONS: @entity453 was associated with better outcomes than on-pump coronary artery bypass despite a similar predicted risk. This robust finding was documented on sensitive CUSUM analysis, using standard statistical techniques and on a multivariable analysis of the independent predictors of hospital length of stay.

Effect of XXXX on risk-adjusted and cumulative sum failure outcomes after coronary artery surgery.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity453 :: ('MESH:D003324', 'Disease') :: ['OPCAB', 'off-pump coronary artery bypass grafting'] @entity64 :: ('MESH:D020521', 'Disease') :: ['postoperative stroke']
@entity453 :: (MESH:D003324,Disease) :: ['off-pump coronary artery bypass grafting']
