Minhas, AMK, Abramov, D, Chung, JS, Patel, J, Mamas, MA, Zieroth, S, Agarwal, R, Fudim, M and Rabkin, DG (2022) Current status of perioperative temporary mechanical circulatory support during cardiac surgery. Journal of Cardiac Surgery. ISSN 1540-8191

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OBJECTIVES: We sought to determine utilization and outcomes of perioperative temporary mechanical circulatory support (tMCS) in the current practice of cardiac surgery. BACKGROUND: tMCS is an evolving adjunct to cardiac surgery not fully characterized in contemporary practice. METHODS: Using the nationwide inpatient sample we retrospectively analyzed hospital discharge data between January 1, 2016 and December 31, 2019. ICD-10-CM procedure codes were used to identify and divide patient hospitalizations into those who had preoperative tMCS (pre-tMCS) versus tMCS instituted the day of surgery or afterwards (sd/post-tMCS). RESULTS: In all, 1,383,520 hospitalizations met inclusion criteria. 86,445 (6.25%) had tMCS. tMCS was utilized in 8.74% of coronary artery bypass grafting (CABG), 2.58% of isolated valve, and 9.71% of valve/CABG; operations. 29,325 (33.9%) had pre-tMCS while 57,120 (66.1%) had sd/post-tMCS. The use of tMCS was associated with greater inpatient mortality (15.66% vs. 1.53%, p < .001), longer length of stay (LOS) (14.4 vs. 8.5 days, p < .001), and higher mean inflation-adjusted costs ($93,040 ± 1038 vs. $51,358 ± 296, p < .001) compared to no use. Inpatient mortality (5.98% vs. 20.63%, p < .001), LOS (13.87 vs. 14.68, p < .001), and cost ($82,621 ± 1152 SEM vs. $98,381 ± 1242) were all significantly lower with pre-tMCS compared to sd/post tMCS. When analyzed separately, mortality was higher with later utilization of tMCS (5.98% pre, 17.1% sd, and 49.05% postsurgical date insertion, p < .001). CONCLUSIONS: Perioperative tMCS is utilized in 6.25% of modern cardiac surgery, with two-thirds of cases instituted on the day of surgery or afterwards. The use of tMCS is associated with significantly higher mortality, longer LOS, and higher costs. Among patients undergoing tMCS, earlier utilization is associated with better outcomes.

Item Type: Article
Additional Information: This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.© 2022 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC.
Subjects: R Medicine > R Medicine (General)
R Medicine > RD Surgery
R Medicine > RD Surgery > RD32 Operative surgery. Technique of surgical operations
Related URLs:
Depositing User: Symplectic
Date Deposited: 22 Nov 2022 13:34
Last Modified: 22 Nov 2022 13:34
URI: https://eprints.keele.ac.uk/id/eprint/11697

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