Abstract 31: Center-specific Variation in Use of Dual Antiplatelet Therapy Prior to Coronary Surgery: an Outcomes Analysis from the Maryland Cardiac Surgery Quality Initiative

Background: Understanding institutional practices and associated outcomes of patients managed with different dual antiplatelet therapy (DAPT) strategies prior to coronary artery bypass grafting (CABG) could inform practice improvement. We hypothesized that, while receipt of DAPT within 5 days prior to CABG would increase risk for postoperative bleeding, there is institutional variation in preoperative DAPT management. Methods: A retrospective cohort study was performed using data from the Maryland Cardiac Surgery Quality Initiative (MCSQI), a consortium aggregating data from the 10 hospitals that perform cardiac surgery in Maryland. Isolated CABG patients between 2011 and 2018 were included. The exposure variable of interest was DAPT use within 5 days prior to CABG. The temporal trend in preoperative use of DAPT, heterogeneity in DAPT usage between centers, and perioperative outcomes are reported. The primary outcomes were the STS major morbidity/mortality composite measure and postoperative bleeding even...