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J Thorac Cardiovasc Surg 2004;127:174-178
© 2004 The American Association for Thoracic Surgery

Surgery for acquired cardiovascular disease

Coronary artery bypass grafting: Are risk models developed from on-pump surgery valid for off-pump surgery?

YingXing Wu, MDa,*, Gary L. Grunkemeier, PhDa, John R. Handy, Jr, MDa

a Providence Health System, Portland, Ore, USA.

Received for publication June 19, 2003; revisions received August 13, 2003; accepted for publication August 21, 2003.

* Address for reprints: YingXing Wu, MD, 9205 SW Barnes, #33LL, Portland, OR 97225, USA
yingxing.wu{at}providence.org

OBJECTIVE: This study was undertaken to test whether risk models developed from on-pump coronary artery bypass grafting are valid for assessing the risk for off-pump coronary artery bypass grafting.

METHODS: From January 1997 through June 2002, a total of 12,845 patients underwent isolated coronary artery bypass grafting procedures in Providence Health System hospitals. Of these, 1782 operations (14%) were performed without cardiopulmonary bypass. An operative mortality risk model was derived from on-pump data with logistic regression. This model and two other external risk models developed from on-pump data were then applied to patients undergoing off-pump coronary artery bypass grafting to test the model adequacy.

RESULTS: Good model discrimination and calibration were obtained from all three models.

CONCLUSION: Operative mortality risk models developed from on-pump coronary artery bypass grafting can be used to assess the risk for off-pump coronary artery bypass grafting.




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