Abstract 16232: Early Morbidity Affects Survival Beyond the Perioperative Period in On-Pump vs. Off-Pump Coronary Artery Bypass Graft Surgery - A Quantitative Morbidity Analysis of the CORONARY Trial
Bibliographic record
Abstract
Introduction: Previous large trials found similar outcomes between on- and off-pump CABG. We assessed the hypothesis that quantified early morbidity affects survival after 30 postoperative days by applying the Clavien-Dindo Complications Classification (CDCC) and the Comprehensive Complication Index (CCI) to the CORONARY trial. Methods: All postoperative hospitalization and 30-days follow-up complications were assigned a CDCC grade. CCI were calculated for all patients (n=4752) ( Table 1 ). Kaplan-Meier analysis was used to examine 1-year mortality by CDCC grade in patients alive after 30 postoperative days. Wilcoxon and log-rank were used for comparisons. Results: Median CDCC was 1 [interquartile range: 0, 2] for off-pump and 2 [1, 2] for on-pump CABG (p<0.001). Median CCI was 8.7 [0, 22.6] for off-pump and 20.9 [8.7, 29.6] for on-pump CABG (p<0.001). In on-pump CABG, there were more grade I complications (off: n=1093, 46.0% vs. on: n=1280, 53.8%; p<0.001) and grade II complication (off: n=903, 38.0% vs. on: n=1012, 42.6%; p<0.001) ( Figure 1a ). In on-pump CABG, 17.5% (n=417) had grade IIIa or greater morbidity versus 15.9% (n=378) in off-pump (p=0.133). Survival curves differed significantly based on CDCC grade ( Figure 1b , p<0.001). The CCI was 8.7 [0, 22.6] in patients who survived (n=4514) and 22.6 [8.7, 44.3] in patients who died (n=94) at one year (p<0.001). Conclusions: On-pump CABG is associated with greater early morbidity graded by CDCC and CCI. This affects survival beyond the immediate postoperative period. Similar quantitative analyses have not been used to compare the two techniques and could prove useful to better quantify procedural morbidity in clinical trials.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.004 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 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 source (direct Gemma or distilled Codex), 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".