Outcomes after coronary artery bypass grafting in Spain. Minimum Basic Dataset Analysis from 2001 to 2020

Introduction and objectives: To analyze the recent evolution of the risk profile, mortality and burden of healtcare delivery of coronary artery bypass grafting (CABG) in Spain. Methods: Episodes with any isolated CABG coded procedure were retrieved from Minimum Basic Data Set between 2001 & 2020. The study period was divided in 4: 2001-2005, 2006-2010, 2011-2015 and 2016-2020. Changes in activity volume and factors associated to in-hospital mortality were analyzed using linear trend analysis and multivariate logistic regression models. Results: We included 96,073 episodes in which isolated CABG was performed. A reduction in the annual volume of procedures was observed from 6134 in 2001 to 3421 in 2020, and an increase in the coronary intervention/surgery ratio from 2.4 to 8. Between the first and the last period, we detected an increase in the prevalence of almost all comorbidities with an uprising of mean Charlson's index from 2.99 to 3.68 (P<.001). Nevertheless, mortality was reduced from 6.2% to 2.6% (P<.001) and the risk-adjusted mortality rate from 1.84 to 0.51 (P<.001). The CABG volume of healthcare centers was independently associated to a lower mortality independently (P<.001) Conclusions: Between 2001 and 2020, the volume of CABG in Spain was significantly reduced. Despite a worsening of the risk profile, we detected a decrease in mortality. The volume of procedures has a decisive impact in the performance of CABG. (c) 2022 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).