Evaluation of the relationship between preoperative risk scores, postoperative and total length of stays and hospital costs in coronary bypass surgery

Kurki, Tuula S.; Häkkinen, Unto; Lauharanta, J; Rämö, Juhani; Leijala, M.

doi:10.1016/s1010-7940(01)00988-5

Cited by 54 publications

(43 citation statements)

References 8 publications

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“…As a consequence, the total duration of hospital stay was similar to that reported by other studies (8.3 and 7.3 days) 24,25 .…”

Section: Arq Bras Cardiol 2006; 87 : 410-415supporting

confidence: 88%

“…Group without other resulting complications and without an increment of duration of hospital stay, with the sample mean being 8 and 9 days (groups A and B), similar to what is reported in literature 5,24 . The MPI was not a predictor of these events.…”

Section: Major Eventssupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

“…This index can be easily obtained and reproduced, regardless of the ventricular geometry, which makes it adequate for the assessment of the overall ventricular function in several clinical situations 10,11 . The index is defined as the sum of the isovolumetric contraction time and isovolumetric relaxing time divided by the ejection time through the Doppler analysis at the mitral inflow and the left ventricular outflow velocity and time [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] , being considered a possible assessment factor for total cardiac function and cardiac prognosis predictor 10,12,13 . Several studies have evaluated MPI in patients with acute myocardial infarction, miocardiopathy, and valvar disease among others, and the index presented an elevated prediction power for the development of unfavorable outcomes 10,[13][14][15][16][17][18]26 .…”

mentioning

confidence: 99%

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Valor prognóstico do índice de performance miocárdica no pós-operatório de cirurgia de revascularização miocárdica

Azzolin¹,

Castro²,

Feier³

et al. 2006

Arq. Bras. Cardiol.

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objective: Myocardial Performance Index (MPI) obtained by Doppler echocardiography for the non-geometrical evaluation of systolic and diastolic function has been described as a method for prognostic evaluation in patients with acute myocardial infarction (AMI). Using the same condition, the objective of this study was to evaluate the predictive value of MPI for cardiovascular complications in patients at low risk during the postoperative period of CABG. Methods:Eighty patients submitted to CABG with adequate left ventricular function in the preoperative period were studied, with MPI measured during the first hours postoperatively. Patients were followed until hospital discharge. Statistical analysis included Chi-Square test, Student t test, Mann-Whitney test, and estimation of relative risks with 95% confidence intervals, sensitivity and specificity plus a ROC curve. results:The data were evaluated by two independent observers blinded to the clinical data with non-significant intra and interobserver variability. MPI=0.43 was found as the cutoff point, considering patients with a higher probability of postoperative events those who had MPI above 0.43. The relevant events for analysis were AMI (RR 0.87 ci 0.21-3.65), atrial fibrillation (RR 0.65 ci 0.24 -1.76), other arrhythmias (RR 1.51 ci 0.36-6.33), LV dysfunction (RR 1.74 ci 0.32-9.88), with no association between patients with MPI>0.43 and the occurrence of these events. conclusion:No association was found between MPI and cardiovascular complications and longer hospital stay in this group of patients, and this index was considered not adequate as an isolated predictive method.Key words: Coronary artery bypass graft, low risk, morbidity, myocardial performance index (MPI) and prognostic outcome.The post-surgical morbimortality of coronary artery bypass graft (CABG) surgery is of great interest, resulting in several protocols of post-operative management and risk models aiming at decreasing cardiovascular complications 1 .The presence of left ventricular dysfunction and cardiac failure in the postoperative period of CABG has been considered one of most important independent predictive factors of surgical mortality [2][3][4][5] , with an association between the severity of the left ventricular dysfunction and risk of complications (4% to 10% for moderate to severe ventricular dysfunction) 3 .Cardiac surgery complications in patients with adequate left ventricular function in the pre-operative period have a low prevalence 2 ; therefore, they are hardly studied. In this group, the identification of alterations in the overall function of the left ventricle in the immediate post-operative period would allow early interventions, resulting in lower surgical morbimortality 6,7 .Non-invasive measurements of time intervals used for the assessment of the systolic and diastolic functions were proposed by Mancini 8 through phonomechanocardiography and reintroduced by Tei et al 9 in 1995 and showed to be easily obtained by conventional Doppler, with time intervals, combining...

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“…As a consequence, the total duration of hospital stay was similar to that reported by other studies (8.3 and 7.3 days) 24,25 .…”

Section: Arq Bras Cardiol 2006; 87 : 410-415supporting

confidence: 88%

Section: Major Eventssupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Valor prognóstico do índice de performance miocárdica no pós-operatório de cirurgia de revascularização miocárdica

Azzolin¹,

Castro²,

Feier³

et al. 2006

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

show abstract

“…It is important to emphasize that ES can only shows the risks and not the benefits. Although it is to be noted that patients exact scores can only be determined by someone who has access to all the detailed medical history [19]. ES is considered as a synthetic proxy for the admission health status of the patient and it is assumed that there exists a relation between the ES and the LoS that is considered to be a reliable and valid proxy for measuring the consumption of hospital resources [16].…”

Section: Advanced Data Analysismentioning

confidence: 99%

Evaluation of indices for the measurement of quality in health systems

Clemente

Papi

Pontecorvi

et al. 2016

Int. J. Metrol. Qual. Eng.

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Abstract. In recent decades different numeric indicators and methods have been used to qualify structured index that express health service components quality performance. The first step of this work is the definition of a model of the system under examination in order to define its measurable constituent entities (dimensions). Among the common measured clinical parameters, a robust metrics, characterizing the constituent entities and the best opportunity tools for the characterization of the results, have been identified. The last step is multimodal analysis of the results. Using this approach the paper presents an application in the evolution of the cardiological intensive care unit (ICU). Particularly, the attention of this paper is focused on the evolving of the medical team.

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Risk adjusted resource utilization for AMI patients treated in Japanese hospitals

et al. 2006

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Though risk adjustment is necessary in order to make equitable comparisons of resource utilization in the treatment of acute myocardial infarction patients, there is little in the literature that can be practically applied without access to clinical records or specialized registries. The aim of this study is to show that effective models of resource utilization can be developed based on administrative data, and to demonstrate a practical application of the same models by comparing the risk-adjusted performance of the hospitals in our dataset. The study sample included 1748 AMI cases discharged from 10 large, private teaching hospitals in Japan, between 10 April 2001 and 30 June 2004. Explanatory variables included procedures (CABG and PCI), length of stay, outcome, patient demographics, diagnosis and comorbidity status. Multiple linear regression models constructed for the study were able to account for 66.5, 27.7, and 58.4% of observed variation in total charges, length of stay and charges per day, respectively. The performance of models constructed for this study was comparable to or better than performance reported by other studies that made use of explanatory variables extracted from clinical data. The use of administrative data in risk adjustment makes broad scale application of risk adjustment feasible.

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Evaluation of the relationship between preoperative risk scores, postoperative and total length of stays and hospital costs in coronary bypass surgery

Cited by 54 publications

References 8 publications

Valor prognóstico do índice de performance miocárdica no pós-operatório de cirurgia de revascularização miocárdica

Valor prognóstico do índice de performance miocárdica no pós-operatório de cirurgia de revascularização miocárdica

Evaluation of indices for the measurement of quality in health systems

Risk adjusted resource utilization for AMI patients treated in Japanese hospitals

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