Custos hospitalares da cirurgia de revascularização do miocárdio em pacientes coronarianos eletivos

Haddad, Nagib; Bittar, Eliana; Marchi, Andrea; Kantorowitz, Coralice dos Santos Veiga; Ayoub, Andrea Cotait; Fonseca, Mayuli Lurbe; Piegas, Leopoldo Soares

doi:10.1590/s0066-782x2007000400009

Cited by 16 publications

(15 citation statements)

References 14 publications

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“…The benefits of CABG are identified as contributing factors for reduced fatal outcomes in many cases of associated cardiovascular diseases [1,2]. However, this surgery, besides being expensive, can result in reduced functional capacity due to morbidities acquired postoperatively or risks associated with the procedure [3,4].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting

Oliveira¹,

Turquetto²,

Tauil³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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353Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2013;28(3):353- ORIGINAL ARTICLE Abstract Introduction: Characteristics of the patient and the coronary artery bypass grafting may predispose individuals to prolonged hospitalization, increasing costs and morbidity and mortality.Objective: The objective of this study was to evaluate individual and perioperative risk factors of prolonged hospitalization in intensive care units and wards.Methods: We conducted a case-control study of 104 patients undergoing isolated coronary artery bypass grafting with cardiopulmonary bypass. Patients hospitalized >3 days in the intensive care unit or >7 days in the ward were considered for the study. The association between variables was estimated by the chi-square test, odds ratio and logistic regression; P ≤0.05 was considered statistically significant.Results: Hospital stay >3 days in the intensive care unit occurred for 22.1% of patients and >7 days in the ward for 27.9%. Among preoperative factors, diabetes (OR=3.17) and smoking (OR=4.07) were predictors of prolonged intensive care unit stay. Combining the pre-, intra-and postoperative variables, only mechanical ventilation for more than 24 hours (OR=6.10) was predictive of intensive care unit outcome. For the ward outcome, the preoperative predictor was left ventricular ejection fraction <50% (OR=3.04). Combining pre-and intraoperative factors, diabetes (OR=2.81), and including postoperative factors, presence of infection (OR=4.54) were predictors of prolonged hospitalization in the ward.Conclusion: Diabetes and smoking were predictors of intensive care unit outcome, and ejection fraction <50% of ward outcome. For the set of perioperative factors, prolonged hospitalization after isolated coronary artery bypass grafting was associated with mechanical ventilation >24 hours for the intensive care unit and presence of infection for the ward.Descriptors: Risk factors. Myocardial revascularization. Hospitalization. ResumoIntrodução: Características do paciente e da cirurgia de revascularização do miocárdio podem predispor à internação prolongada, aumentando custos e a morbimortalidade.Objetivo: Avaliar fatores de risco individuais e transoperató-rios para internação prolongada na unidade de terapia intensiva e na enfermaria. 354Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(3):353-63 Oliveira EK, et al. -Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting productivity [4,8], affecting family budgets, quality of life and increasing costs [1]. Bashour et al. [7] showed that, after cardiac surgery, many patients with prolonged hospital stay died soon after discharge and that the functional status of those who survived for a longer period was worse when compared with those who recovered faster. RevIn this context, the objective of this study was to identify pre-, intra-and postoperative risk factors for long hospitalizations in the ICU or the ward, of patients undergoing isolated CABG surgery w...

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Section: Introductionmentioning

confidence: 99%

Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting

Oliveira¹,

Turquetto²,

Tauil³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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“…The highest mean costs were in the operating room (R$ 4,627.97) and in the immediate postoperative period (R$ 1,221.39), followed by the nursing care after the immediate postoperative period (R$ 840.04) and the initial preoperative nursing care (R$ 300.90) 26 . In the SRJ, the mean relative cost was higher in most hospitals, of US$ 3,088.12.…”

Section: Year N Of Camentioning

confidence: 99%

Desempenho e gastos do SUS com revascularizações do miocárdio no Estado do Rio de Janeiro, de 1999 a 2008

Oliveira¹,

Klein²,

Silva³

2011

Arq. Bras. Cardiol.

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. In the analysis of decreasing mortality trends due to IHD, multiple factors must be considered, including age, sex, diagnosis, therapeutic interventions and environmental and socioeconomic conditions. The studies with data recorded from clinical practice provide a view that is closer to reality than the experimental ones 3 .In a study with samples of coronary angiography (CA) records performed in public hospitals in the city of Rio de Janeiro (CRJ), from 1999 to 2003, a mean in-hospital mortality of 1.6% was observed, ranging from 0.9 % to 6.8%. Mortality rates in primary and rescue CA were 17.4% and 13.1%, and in elective CA, it was 0.8% 4 . During the same period, in 2,692 coronary artery bypass graft (CABG) records in the CRJ, a variation between hospitals was observed, from 7.0% to 14.3% in the in-hospital period, and 8.5% to 20.2 % up to one year post-hospital release and a significant association between the occurrence of complications and postoperative death (p <0.0001) 5. Therefore, regarding myocardial revascularization procedures, the minimum required performance was not observed in the SRJ 6 , representing an important financial burden for the Brazilian Public Health System (SUS), with individual and social consequences 7 .In the middle of the last decade of the twentieth century, it was estimated that 80% of medical or hospital care was financed by the Public Health System (SUS) in Brazil

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“…Na perspectiva das pesquisas realizadas, seus gestores continuam a não possuir informações no nível de sofisticação necessário para dar suporte adequado às necessidades inerentes às contingências internas e externas (Costa, 2010;Forgia & Couttolenc, 2009;Gonçalves, 2006;Haddad et al, 2007;Oliva & Borba, 2004).…”

Section: Introductionunclassified

Determinantes Contingenciais que Contribuem para Efetividade do Sistema de Custeio em Hospitais: Um Estudo de Caso em um Hospital do Vale do Itajaí - SC

Silva¹,

Scarpin²,

Barp³

et al. 2013

RGSS

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Custos hospitalares da cirurgia de revascularização do miocárdio em pacientes coronarianos eletivos

Cited by 16 publications

References 14 publications

Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting

Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting

Desempenho e gastos do SUS com revascularizações do miocárdio no Estado do Rio de Janeiro, de 1999 a 2008

Determinantes Contingenciais que Contribuem para Efetividade do Sistema de Custeio em Hospitais: Um Estudo de Caso em um Hospital do Vale do Itajaí - SC

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