TY - JOUR
T1 - Critical outcomes in nonrobotic vs robotic-assisted cardiac surgery
AU - Yanagawa, Franz
AU - Perez, Martin
AU - Bell, Ted
AU - Grim, Rod
AU - Martin, Jennifer
AU - Ahuja, Vanita
N1 - Publisher Copyright:
© 2015 American Medical Association. All rights reserved.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - IMPORTANCE As robotic-assisted cardiac surgical procedures increase nationwide, surgeons need to be educated on the safety of the new modality compared with that of open technique. OBJECTIVE To compare complications, length of stay (LOS), actual cost, and mortality between nonrobotic and robotic-assisted cardiac surgical procedures. DESIGN, SETTING, AND PARTICIPANTS Weighted data on cardiac patients who had undergone operations involving the valves or septa and vessels, as well as other heart and pericardium procedures, from January 1, 2008, to December 31, 2011, were obtained from the Nationwide Inpatient Sample via the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. Propensity score matching was used to match each robotic-assisted case to 2 nonrobotic cases on 14 characteristics. MAIN OUTCOMES AND MEASURES Complications, median LOS, actual cost, and mortality. RESULTS Exploratory analysis found a total of 1 374 653 cardiac cases (1 369 454 [99.6%] nonrobotic and 5199 [0.4%] robotic-assisted cases). After propensity score matching, there were 10 331 (66.5%) nonrobotic cases and 5199 (33.5%) robotic-assisted cases. Cardiac operations included 1630 (10.5%) involving the valves or septa, 6616 (42.6%) involving the vessels, and 7284 (46.9%) other heart and pericardium procedures. Robotic-assisted compared with nonrobotic surgery had a higher median cost ($39 030 vs $36 340; P <.001) but lower LOS (5 vs 6 days; P <.001) and lower mortality (1.0% vs 1.9%; P <.001). Robotic-assisted surgery had significantly fewer complications for all operation types (30.3% vs 27.2%; P <.001). CONCLUSIONS AND RELEVANCE Overall, robotic-assisted surgery has significantly reduced median LOS, complications, and mortality compared with nonrobotic surgery. Results of this study support the contention that robotic-assisted surgery is as safe as nonrobotic surgery and offers the surgeon an additional technique for performing cardiac surgery.
AB - IMPORTANCE As robotic-assisted cardiac surgical procedures increase nationwide, surgeons need to be educated on the safety of the new modality compared with that of open technique. OBJECTIVE To compare complications, length of stay (LOS), actual cost, and mortality between nonrobotic and robotic-assisted cardiac surgical procedures. DESIGN, SETTING, AND PARTICIPANTS Weighted data on cardiac patients who had undergone operations involving the valves or septa and vessels, as well as other heart and pericardium procedures, from January 1, 2008, to December 31, 2011, were obtained from the Nationwide Inpatient Sample via the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. Propensity score matching was used to match each robotic-assisted case to 2 nonrobotic cases on 14 characteristics. MAIN OUTCOMES AND MEASURES Complications, median LOS, actual cost, and mortality. RESULTS Exploratory analysis found a total of 1 374 653 cardiac cases (1 369 454 [99.6%] nonrobotic and 5199 [0.4%] robotic-assisted cases). After propensity score matching, there were 10 331 (66.5%) nonrobotic cases and 5199 (33.5%) robotic-assisted cases. Cardiac operations included 1630 (10.5%) involving the valves or septa, 6616 (42.6%) involving the vessels, and 7284 (46.9%) other heart and pericardium procedures. Robotic-assisted compared with nonrobotic surgery had a higher median cost ($39 030 vs $36 340; P <.001) but lower LOS (5 vs 6 days; P <.001) and lower mortality (1.0% vs 1.9%; P <.001). Robotic-assisted surgery had significantly fewer complications for all operation types (30.3% vs 27.2%; P <.001). CONCLUSIONS AND RELEVANCE Overall, robotic-assisted surgery has significantly reduced median LOS, complications, and mortality compared with nonrobotic surgery. Results of this study support the contention that robotic-assisted surgery is as safe as nonrobotic surgery and offers the surgeon an additional technique for performing cardiac surgery.
UR - http://www.scopus.com/inward/record.url?scp=84939805836&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84939805836&partnerID=8YFLogxK
U2 - 10.1001/jamasurg.2015.1098
DO - 10.1001/jamasurg.2015.1098
M3 - Article
C2 - 26083734
AN - SCOPUS:84939805836
SN - 2168-6254
VL - 150
SP - 771
EP - 777
JO - JAMA surgery
JF - JAMA surgery
IS - 8
ER -