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

Abstract

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...

Factors associated with intubation extended in patients who undewent a heart surgery

“…In this study, there was a predominance of males (60.9%), which corroborates other findings (FINZI, 2010;WIDYASTUTI et al, 2012;OLIVEIRA et al, 2013;TOTONCHI et al, 2014).…”

“…Similar findings were found in a study that aimed to evaluate the perioperative risk factors for a prolonged hospitalization, in which the mean BMI was 27 kg/m 2 (OLIVEIRA et al, 2013). As regards to smoking habits, there was a higher frequency of smoking patients.…”

“…A similar result was found in a study conducted at the Cardiology Institute of the Federal District, which aimed to assess individual and intraoperative risk factors for a prolonged stay in the ICU and in the infirmary, in which 87 patients (83.7%) had SAH and 42 (40 4%) had diabetes mellitus type II (OLIVEIRA et al, 2013).…”

Diagnósticos de enfermagem no pós-operatório imediato de cirurgia de troca de válvula

“…5,[11][12][13] Tendo em vista que diversos destes aspectos podem contribuir para aumentar o tempo de permanência em Unidade de Terapia Intensiva (UTI) e tempo de ventilação mecânica. 11,[14][15] Estudo recente demonstrou que o diabetes mellitus (DM) é um preditor para tempo prolongado de UTI, ou seja, pacientes diabéticos apresentam maior chance de permanecerem internados nestas unidades, por um maior período de tempo, em relação aos pacientes não diabéticos. 14 Além disso, diversos aspectos como DM, HAS, tabagismo, dislipidemia e idade avançada, estão associados ao aumento da necessidade do uso de ventilação mecânica ou ventilação mecânica prolongada (VM).…”

“…11,[14][15] Estudo recente demonstrou que o diabetes mellitus (DM) é um preditor para tempo prolongado de UTI, ou seja, pacientes diabéticos apresentam maior chance de permanecerem internados nestas unidades, por um maior período de tempo, em relação aos pacientes não diabéticos. 14 Além disso, diversos aspectos como DM, HAS, tabagismo, dislipidemia e idade avançada, estão associados ao aumento da necessidade do uso de ventilação mecânica ou ventilação mecânica prolongada (VM). 15 Assim, pacientes tabagistas que não suspenderam o cigarro até quatro semanas antes do procedimento cirúrgico, podem apresentar maior permanência na UTI, devido à dificuldade existente na adequada oxigenação, exigindo maior tempo em ventilação mecânica.…”