Abstract 14977: Radial Artery Usage Rate Differs in Hospital Types in Coronary Artery Bypass Graft Surgery: An Insight Into National Inpatient Sample

Abstract

Introduction: In coronary artery bypass grafting (CABG), the left internal mammary artery (LIMA) may not be utilized, and a secondary conduit is chosen to treat coronary artery disease. Radial artery (RA) and greater saphenous vein (GSV) are both viable secondary conduits to, although RA grafting is associated with higher patency and superior long-term survival. This study aimed to compare the rate of RA graft usage in CABG among different hospital types. Methods: Patients received CABG between Q4 2015-2020 were extracted from National Inpatient Sample (NIS) based on ICD10-PCS. Patients less than the age of 40 were excluded for congenital heart defects. Preoperative variables included sex, age, race and ethnicity, socioeconomic status (SES), Elixhauser comorbidities, and hospital characteristics. The rate of RA versus GSV usage were compared with respect to hospital location/teaching status and bed sizes, while all preoperative variables besides the variable of interest were adjusted by multivariable analysis. Results: There were 56,318 CABG cases identified with 11,708 RA and 44,610 GSV grafting. RA grafting usage was lower in rural hospitals (aOR 0.59, p<0.01), urban private practice (aOR 0.69, p<0.01), and hospitals with large bed sizes (aOR 0.91, p<0.01) while the rate is higher in urban teaching hospitals (aOR 1.50, p<0.01) and hospitals with medium bed sizes (aOR 1.14, p<0.01). Conclusion: This study reveals different RA graft usage for CABG among different hospital types. RA harvest can be more time consuming and resource intensive than GSV harvest. Increased familiarity overcoming these obstacles might increase RA graft usage.