Outcomes of Coronary Surgery at a Veterans Affairs Hospital Versus Other Hospitals
Outcomes of Coronary Surgery at a Veterans Affairs Hospital Versus Other Hospitals
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DOI：
10.1016/j.jss.2009.03.041
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发表时间：
2009-09-01
影响因子：
2.2
通讯作者：
Chu, Danny
中科院分区：
文献类型：
--
作者：
Choi, Justin C.;Bakaeen, Faisal G.;Chu, Danny
背景。本研究的目的是比较VA医院和非VA医院的冠状动脉旁路移植术（CABG）手术的结果。材料与方法。利用2004年全国住院患者样本数据库，我们确定了48,669名在非VA医院接受CABG的患者的出院记录，并将这些患者的结果与2002年至2006年在VA医院接受CABG的688名患者的结果进行了比较。使用学生t检验和chi(2)检验来确定显著的组间差异。VA患者比非VA患者稍年轻（62 +/- 8 vs 66 +/- 11, P < 0.0001）。VA患者既往心肌梗死（60.6%比34.6%）、充血性心力衰竭（38.2%比22.1%）、外周血管疾病（25.9%比7.2%）、脑血管疾病（23.4%比5.9%）、慢性阻塞性肺疾病（32.3%比16.6%）和糖尿病（41.7%比29.7%）的患病率也更高（所有患者P < 0.0001）。尽管如此，VA患者的住院死亡率明显低于非VA患者（1.6%对3.0%,P = 0.03）。尽管合并症的发生率较高，但在VA医院接受CABG的患者死亡率明显低于非VA医院的CABG患者。Elsevier Inc.出版。版权所有。
Background. The aim of this study was to compare outcomes of coronary artery bypass grafting (CABG) operations at a VA hospital and non-VA hospitals.Materials and Methods. Using the 2004 Nationwide Inpatient Sample database, we identified 48,669 discharge records of patients who underwent CABG in non-VA hospitals and compared these patients' outcomes with those of 688 patients who underwent CABG at our VA hospital from 2002 to 2006. Student t- tests and chi(2) tests were used to identify significant intergroup differences.Results. The VA patients were slightly younger than the non-VA patients (62 +/- 8 versus 66 +/- 11 y, P < 0.0001). The VA patients also had a higher prevalence of prior myocardial infarction (60.6% versus 34.6%), congestive heart failure (38.2% versus 22.1%), peripheral vascular disease (25.9% versus 7.2%), cerebral vascular disease (23.4% versus 5.9%), chronic obstructive pulmonary disease (32.3% versus 16.6%), and diabetes (41.7% versus 29.7%) (P < 0.0001 for all). Nonetheless, the in-hospital mortality rate was significantly lower in VA patients than in non-VA patients (1.6% versus 3.0%, P = 0.03).Conclusions. Despite the higher prevalence of comorbidities, patients who underwent CABG at a VA hospital had a significantly lower mortality rate than CABG patients in non-VA hospitals. Published by Elsevier Inc. All rights reserved.