The Southern Arizona VA Health Care System and University of Arizona Sarver Heart Center, 1501 N Campbell Ave, Tucson, AZ 85724, USA.
J Thorac Cardiovasc Surg. 2010 Jun;139(6):1545-7. doi: 10.1016/j.jtcvs.2009.08.044. Epub 2009 Oct 23.
This study examined nationwide trends in use of coronary artery bypass grafting between 1988 and 2004.
The Nationwide Inpatient Sample database was used to calculate age-adjusted rate of coronary artery bypass grafting from 1988 to 2004. Specific International Classification of Diseases, Ninth Revision, Clinical Modification codes for coronary artery bypass grafting were used to compile data. Patient demographic data were also analyzed.
The database recorded 1,145,285 patients older than 40 years who underwent coronary artery bypass grafting from 1988 to 2004. Mean age was 60.21 +/- 10.55 years. Male patients underwent coronary artery bypass grafting more than twice as frequently as female patients (70.6% vs 29.4%). From 1988, total age-adjusted rate gradually increased for 10 years until 1997 (79.29 per 100,000 with 95% confidence interval 70.88-87.71 per 100,000 in 1988, 131.31 per 100,000 with 95% confidence interval 119.02-143.59 per 100,000 in 1997, P < .01), with ensuing rapid decline to nearly the lowest level at end of study in 2004 (83.01 per 100,000 with 95% confidence interval 75.68-90.33 per 100,000, P < .01). Although trends were similar across ethnicity and sex, female and ethnic minority patients had lower rates of bypass surgery than did male and white patients.
Use of coronary artery bypass grafting has decreased dramatically in recent years, with even lower use among female and ethnic minority patients. This decline may be related to significant advances in percutaneous coronary interventions and improved medical treatment of atherosclerosis in the past 10 years.
本研究旨在探讨 1988 年至 2004 年期间冠状动脉旁路移植术的使用情况。
利用全国住院患者样本数据库，计算了 1988 年至 2004 年期间的冠状动脉旁路移植术年龄调整率。使用特定的国际疾病分类，第九修订版，临床修正代码来编译数据。还分析了患者的人口统计学数据。
该数据库记录了 1988 年至 2004 年期间 1145285 名年龄大于 40 岁的接受冠状动脉旁路移植术的患者。平均年龄为 60.21 ± 10.55 岁。男性患者接受冠状动脉旁路移植术的频率是女性患者的两倍多（70.6%比 29.4%）。自 1988 年以来，总年龄调整率在 10 年内逐渐增加，直到 1997 年（79.29/100,000，95%置信区间 70.88-87.71/100,000 在 1988 年，131.31/100,000，95%置信区间 119.02-143.59/100,000 在 1997 年，P<.01），随后迅速下降至研究结束时的最低水平，即 2004 年（83.01/100,000，95%置信区间 75.68-90.33/100,000，P<.01）。尽管各民族和性别之间的趋势相似，但女性和少数民族患者的旁路手术率低于男性和白人患者。
近年来，冠状动脉旁路移植术的使用量显著下降，女性和少数民族患者的使用量更低。这种下降可能与过去 10 年来经皮冠状动脉介入治疗的显著进步和动脉粥样硬化的医疗治疗改善有关。
