Risk Factors for Failed “Fast-Tracking” After Cardiac Surgery in Patients Older Than 70 Years

Kogan, Alexander; Ghosh, Piyali; Preisman, Sergey; Tager, Salis; Sternik, Leonid; Lavee, Jacob; Kasiff, Igal; Raanani, Ehud

doi:10.1053/j.jvca.2008.02.001

Cited by 28 publications

(22 citation statements)

References 27 publications

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“…The rates of fast-track failure (FTF) reported in the literature vary from 15.6% to 45.5 % in mixed age population 6,7 . A common definition of fast-track is extubation within 6 hours after the end of operation and length of stay in the ICU < 24 hours 11 .…”

Section: Discussionmentioning

confidence: 99%

“…It has been proven by many studies that there is no difference in mortality and morbidity rate between FT anesthesia and conventional anesthesia 2,3 , with the benefit of reduced costs of health care. 4,5 Fast-track failure (FTF) rates reported in the literature vary from 15.6% to 45.5% in mixed age population 6,7 , depending on definition of fast-track failure and patient population (i.e. co-morbidities and type of operation).…”

Section: Introductionmentioning

confidence: 99%

“…In an attempt to work out a standardized protocol for both patient selection and FT process, many studies have evaluated the variables for successful and failing FT treatment in the whole patient population. 3,6,7,9 The aim of this study was twofold: first, to evaluate the rates of FTF and second, to identify independent risk factors for FTF in already preselected fast-track patients undergoing elective cardiac surgery and fast-track treatment.…”

Section: Introductionmentioning

confidence: 99%

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Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients

Zakhary

Lindner

Sgouropoulou

et al. 2015

Journal of Cardiothoracic and Vascular Anesthesia

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients

Zakhary

Lindner

Sgouropoulou

et al. 2015

Journal of Cardiothoracic and Vascular Anesthesia

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“…Several other studies have also found similar effects of blood transfusions and inotropic support on mechanical ventilation duration. [18][19][20] Kogan et al 21 found that kidney failure, stroke, peri-op bleeding and infection as main contributing factors of delayed extubation after surgery. Higgins et also found kidney failure as a risk factor of delayed extubation.…”

Section: Early Extubation (N=55) Delayed Extubation (N=26) P-valuementioning

confidence: 99%

Cardaic Surgery; Risk Factors of Delayed Extubation

Hashmi

2017

TPMJ

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ABSTRACT… Objectives:To identify the risk factors of delayed extubation after cardiac surgery. Study Design: Observational study. Setting: Cardiac surgery in CPE Institute of Cardiology. Period: 2 months from November-2016 to March-2017. Methods: Eighty-one (81) patients who underwent cardiac surgery. In ICU we recorded extubation time of all patients. Patients with extubation time <6 hours after labelled as early extubation group and those with extubation time >6 hours were labelled as delayed extubation group. We recorded their preoperative risk factors and operative variables of surgery to identify the risk factors that leads to late extubation after cardiac surgery (CS). Results: Prevalence of diabetes was significantly high in patients with delayed extubation. There were 42.3% diabetic patients with delayed extubation and only 12.7% diabetic patients with early extubation (p-value 0.003). Total pump time, cross clamp time and type of operation were similar between the groups. Cardiovascular instability was the most common cause of delayed extubation that occurred in 9 patients, reduced level of consciousness in 9 patients, post-op bleeding in 6 patients, while hypoxemia and increased respiratory rate occurred in 1, 1 patient respectively. Conclusion: Diabetes Mellitus is an independent risk factor of delayed extubation after cardiac surgery. Cardiovascular instability, reduced level of consciousness and post-operative bleeding after surgery are the main factors that leads to delayed extubation after CS.

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“…Considering the relatively high proportion of emergency cases Postoperative complications have been reported in approximately 30% to 40% of cases in septuagenarians [15,16] and more in octogenarians [17,18]. Further, it should be noted that the definition of morbidity or the preoperative comorbid state varies among studies.…”

Section: Dong Jin Kim Et Almentioning

confidence: 99%

Clinical Results of Cardiovascular Surgery in the Patients Older than 75 Years

Kim

Park

Isamukhamedov³

et al. 2014

Korean J Thorac Cardiovasc Surg

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Background:The balance of the risks and the benefits of cardiac surgery in the elderly remains a major concern.We evaluated the early and mid-term clinical results of patients aged over 75 years who underwent major cardiovascular surgery. Methods: Two hundred and fifty-one consecutive patients, who underwent cardiac surgery at Seoul National University Bundang Hospital between July 2003 and June 2011, were included in this study (mean age, 78.7±3.4 years; male:female=130:121). Elective surgery was performed in 112 patients, urgent in 90, and emergency in 49. Results: Early mortality was 12.7% (32/251). Follow-up completion was 100%, and the mean follow-up duration was 2.8±2.2 years. Late mortality was 24.2% (53/219). There were 283 readmissions in a total of 109 patients after discharge. However, the reason for readmission was related more to non-cardiac factors (71.3%) than to cardiac factors. The overall survival estimates were 79.2% at the 1-year follow-up and 58.4% at the 5-year follow-up. Patients who underwent elective surgery had a lower early mortality rate (elective, 4.5%; urgent, 13.3%; emergency, 30.6%) and better overall survival rate than those that underwent urgent or emergency surgery (p ＜0.001). Conclusion: The timing of cardiac surgery was found to be an independent risk factor for early and late mortality. Thus, earlier referral and intervention may improve operative results. Further, comprehensive coordinated postoperative care is needed for other comorbid problems in aged patients.

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Risk Factors for Failed “Fast-Tracking” After Cardiac Surgery in Patients Older Than 70 Years

Cited by 28 publications

References 27 publications

Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients

Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients

Cardaic Surgery; Risk Factors of Delayed Extubation

Clinical Results of Cardiovascular Surgery in the Patients Older than 75 Years

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