Abstract
Mortality and complication rates after on-pump versus off-pump coronary artery bypass grafting (CABG), and open lung lobectomy (OL) versus video-assisted lobectomy (VAL), have previously been reported, but further research regarding functional outcomes is needed. This study compared functional recovery at discharge between patients who underwent on-pump versus off-pump CABG, and OL versus VAL. In patients discharged during July to December, from 2006 to 2010, functional recovery was measured by comparing the Barthel index at admission and discharge. Complication rates and functional deterioration were compared in propensity score-matched groups of patients aged over 15 years who underwent isolated CABG of two or more arteries or lobectomy, and survived until discharge. The study included 3,901 on-pump CABG patients, 3,672 off-pump CABG patients, 6,029 OL patients, and 14,378 VAL patients. Patient and hospital characteristics, comorbidities, and preoperative care procedures were associated with on-pump versus off-pump CABG, and OL versus VAL, but functional deterioration was not. The complication rate was lower after VAL than OL. Dependent functional status at admission was associated with functional deterioration in patients who underwent lobectomy. Multidisciplinary treatment strategies to maintain functional status should be developed, and appropriate indications for lobectomy according to functional status at admission should be determined. Key words: Coronary artery bypass grafting, complications, functional outcomes, lung lobectomy.
Highlights
With the increasing size of the elderly population, the number of disabled elderly individuals is increasing
Comparisons of patient characteristics between groups showed that the categories of age, sex, and barthel index (BI) at admission were significantly different between patients who underwent on-pump versus off-pump coronary artery bypass grafting (CABG), and the categories of sex and Charlson comorbidity index (CCI) were significantly different between patients who underwent open lung lobectomy (OL) versus video-assisted lobectomy (VAL)
This study evaluated whether undergoing off-pump versus on-pump CABG, or VAL versus OL was associated with complication rates or functional outcomes
Summary
With the increasing size of the elderly population, the number of disabled elderly individuals is increasing. According to the Organization for Economic Co-operation and Development (OECD) StatExtracts 2011, the proportion of the Japanese population aged over 65 years increased from 9.1% in 1980 to 23.1% in 2010 (for the United States, this proportion increased from 11.3 to 13.0% during the same time period) (OECD StatExtracts, 2011). As a growing number of elderly individuals develop cardiovascular and lung diseases, there is an increasing need for treatments that are less invasive and provide.
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