Abstract P266: Off-Pump Procedure Reduced the Risk Adjusted Mortality and Morbidity of Coronary Bypass Surgery by Half in Comparison With Conventional Procedure, With and Without Propensity Score Matching: Through The Analysis of 11945 Procedures From 120 Hospitals in Japan, Using The Japanese National Database (JACVSD)
Bibliographic record
Abstract
Background & Purpose In Japan off-pump CABG (OPCAB) has much more widely spread than other countries. Recently a couple of papers reported that OPCAB could not show a significant positive effect on the early and mid-term outcome compared with on-pump CABG (OnCAB). The purpose of this study is to compare the effect of OPCAB to OnCAB on the early outcome using the National Database by propensity score matching analysis. Methods Using the Japan Adult Cardiovascular Surgery Database (JACVSD), procedural outcomes were compared for OnCAB and OPCAB between January 1, 2005 and December 31, 2007. The two groups were matched by propensity score. Results A total of 11945 procedures from 120 hospitals were analyzed. OPCAB represented 63% of all CABG procedures, and the raw and risk-adjusted operative mortality of OnCAB vs OPCAB was 2.0% vs 1.0%, and 3.9% vs 1.6%, respectively (Odds ratio 0.46, 95%CI 0.34-0.63). Following propensity score matching, 2283 OnCAB and 2301 OPCAB procedures were compared. The operative mortality was 3.9% and 2.1%, respectively (Odds ratio 0.52, 95%CI 0.37-0.74). In these matched groups, all the major morbidities were significantly reduced in OPCAB; stroke 2.0% vs 1.2% (Odds ratio: 0.42, 95%CI: 0.38-0.98), prolonged ventilation 10.8% vs 6.4% (0.55, 0.45-0.69), .any reason reoperation 5.8% vs 8.4% (0.67, 0.53-0.84), renal failure with new dialysis 4.6% vs 2.7% (0.57, 0.41-0.78), deep sternal infection 3.1% vs 2.0% (0.63, 0.43-0.92). Conclusion OPCAB was much more prevalent in Japan compared with other countries. From our National Database, raw and risk-adjusted mortality and morbidity were significantly lower in OPCAB group than OnCAB group, even after propensity score matching comparison. Further follow-up investigation is warranted to identify the long-term effect of OPCAB.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".