When hospital costs were corrected for inflation, they declined from $26 210 in 1988 to $19 196 in 2005 ($1988) (P 0.0001). Several factors tend to increase the cost of CABG, includ- ing advanced patient age, female sex, African-American ethnicity, postoperative complications, longer hospital stay, and multiple comorbidities, particularly CKD.1244 1247 The National Health Service Foundation Trust in Britain found that patients 75 years of age undergoing CABG had higher rates of postoperative complications and greater resource utilization than their younger counterparts.1244 Similarly, the Maryland Health Services Cost Review Commission reported an increased total cost and length of hospital stay with increasing age in patients undergoing CABG.1245 The same phenomenon was not present with PCI until the patients were 80 years old. In an examination of data from 12 016 subjects undergoing CABG in New York State in 2003, it was determined that older age, female sex, and African-American ethnicity were associated with higher costs.1247 Clinical char- acteristics, such as a lower LVEF, number of diseased vessels, previous open-heart operations, and numerous co- morbidities, further increased costs. Larger hospitals were associated with higher CABG discharge costs, whereas costs significantly decreased with higher CABG volumes. Not surprisingly, perioperative complications lead to in- creased costs. An examination of the Medicare Provider Analysis and Review file of data from 114 223 Medicare beneficiaries who survived CABG in 2005 showed the mean cost of hospitalization associated with CABG to be $32 201 $23 059 for a mean length of stay of 9.9 7.8 days. Those with complications (13.6% of patients) consumed significantly more hospital resources (incremental cost, $15 468) and had a longer length of stay (average additional Evidence for the role of off-pump versus on-pump CABG in decreasing costs is conflicting. 