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Robotic-assisted cardiac surgery reduces length of stay, complications, mortality
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Compared with nonrobotic cardiac surgery, robotic-assisted cardiac surgery is associated with shorter length of stay, fewer complications and reduced mortality, according to study findings.
Researchers obtained weighted data on patients who had undergone surgery between 2008 and 2011 involving the valves or septa and vessels, as well as other heart or pericardium procedures, from the Nationwide Inpatient Sample via the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality.
They conducted propensity score matching on 14 characteristics to match one robotic-assisted case (n = 5,199) with two nonrobotic cases (n = 10,331), and compared the groups with regard to complications, length of hospital stay, overall cost and mortality.
Of the procedures, 10.5% involved the valves or septa, 42.6% involved the vessels and 46.9% involved other aspects of the heart or pericardium.
Franz Yanagawa, MD, and colleagues found that robotic-assisted cardiac surgery had a higher median cost compared with nonrobotic cardiac surgery ($39,030 vs. $36,340; P < .001).
However, robotic-assisted cardiac surgery was associated with shorter length of stay (5 days vs. 6 days; P < .001), lower mortality (1% vs. 1.9%; P < .001) and fewer complications (27.2% vs. 30.3%; P < .001) compared with nonrobotic surgery.
Yanagawa, from the department of general surgery at York Hospital in York, Pennsylvania, and colleagues determined after multiple regression that robotic surgery (OR = 0.627; 95% CI, 0.424-0.926) and elective surgery (OR = 0.58; 95% CI, 0.401-0.838) were not predictors of mortality, but age 80 years or older (OR = 3.119; 95% CI, 1.833-5.307); Charlson comorbidity index score of 4 or higher (OR = 2.826; 95% CI, 1.654-4.831); and undergoing treatment at a rural hospital (OR for urban location = 0.311; 95% CI, 0.113-0.857), a hospital located in the Midwest (OR = 1.878; 95% CI, 1.037-3.399) or at a teaching hospital (OR = 2.733; 95% CI, 1.529-4.885) were predictors of mortality.
“Robotic-assisted surgery appears to have reduced mortality and complications, helping to offset upfront costs,” Yanagawa and colleagues wrote. “Results of this study suggest that robotic-assisted surgery may be as safe as nonrobotic surgery and offer the surgeon an additional technique for performing cardiac surgery. Further studies need to be performed to show long-term benefits, including quality of life and pain scores.” – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
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