• Bharathi H Scott, Frank C Seifert, Roger Grimson, and Peter S A Glass.
• Department of Anesthesiology, SUNY at Stony Brook, Health Sciences Center, Stony Brook, NY 11794-8480, USA. Bharathi.Scott@stonybrook.edu
• J. Cardiothorac. Vasc. Anesth. 2005 Feb 1;19(1):26-31.

ObjectiveThe purpose of the present investigation was to examine factors influencing resource utilization in patients undergoing on-pump coronary artery bypass graft and off-pump coronary artery bypass (OPCAB) graft surgery at a major university hospital. The resources examined were time to extubation, packed red blood cell (PRBC) transfusion, intensive care length of stay (ICULOS), preoperative and postoperative length of stay (PLOS), and total length of stay (LOS).DesignObservational study of consecutive patients undergoing on- and off-pump coronary artery bypass surgery.SettingTertiary care cardiac referral center.ParticipantsOne thousand seven hundred forty-six consecutive male and female patients undergoing primary coronary artery bypass graft (CABG) surgery over a period of 3 years (1999-2001). Eight hundred eighty-one patients underwent CABG with pump, and 865 patients underwent off-pump coronary artery bypass (OPCAB) surgery.InterventionsNone.Measurements And Main ResultsThe mean time to extubation after surgery was 7.4 hours for on-pump patients and 5.8 hours for the OPCAB group (p72 hours to postoperative tracheal extubation compared with 1.5% in the OPCAB group (p=0.041). Hospital mortality was 2.7% for the on-pump group and 1.0% for the OPCAB group (p=0.010).ConclusionThe authors found that patients undergoing on-pump CABG have significantly longer time to tracheal extubation, increased blood use, longer ICULOS, PLOS, and total LOS and higher in-hospital mortality, which would translate into significant differences in the expenses associated with these 2 surgical approaches to coronary surgery.

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