Journal of
Clinical Medicine and Research

  • Abbreviation: J. Clin. Med. Res.
  • Language: English
  • ISSN: 2141-2235
  • DOI: 10.5897/JCMR
  • Start Year: 2009
  • Published Articles: 103

Full Length Research Paper

Coronary artery by pass grafting and lung lobectomy: Functional outcomes at discharge

Kazuaki Kuwabara
  • Kazuaki Kuwabara
  • Kyushu University, Graduate School of Medical Sciences, Department of Health Care Administration and Management, Fukuoka, Japan.
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Shinya Matsuda
  • Shinya Matsuda
  • Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Japan.
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Kiyohide Fushimi
  • Kiyohide Fushimi
  • Department of Health Policy and Informatics, Tokyo Medical and Dental University, Graduate School of Medicine, Tokyo, Japan.
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Koichi B. Ishikawa
  • Koichi B. Ishikawa
  • Economics Section, Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan.
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Hiromasa Horiguchi
  • Hiromasa Horiguchi
  • Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Kenji Fujimori
  • Kenji Fujimori
  • Center for Regional Healthcare and Certified Educator Support, Hokkaido University, Sapporo, Japan.
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  •  Accepted: 22 February 2013
  •  Published: 31 March 2013

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.