Waiting lists in coronary artery bypass graft patients and role of coronary angiography: the Apulian experience

Ciccone, Marco Matteo; Aquilino, Ambrogio; Frasso, Giulia; Avolio, Francesca; Contegiacomo, Barbara; Graps, Elisabetta; Cortese, Francesca; Dentamaro, Ilaria; Petrarolo, Vito; Salvante, Daniela; Salvatore, Anna Maria; Caldarola, Pasquale; Scicchitano, Pietro; Bux, Francesco

doi:10.2147/ca.s41193

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Therefore, we need to deal with the last mechanism of ED overcrowding, the “output”, which addresses the capability of a hospital to make available beds in order to discharge patients thus decongesting the emergency room. It is also true that the flows from the ED to the Hospital Departments, are likely to prolong the waiting lists for elective hospitalization [22–25]. …”

Section: Discussionmentioning

confidence: 99%

Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established

et al. 2016

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IntroductionThe elderly, who suffer from multiple chronic diseases, represent a substantial proportion of Emergency Department (ED) frequent users, thus contributing to ED overcrowding, although they could benefit from other health care facilities, if those were available. The aim of this study was to evaluate and characterize hospital visits of older patients (age 65 or greater) to the ED of a university teaching hospital in Rome from the 1st of January to the 31st of December 2014, in order to identify clinical and social characteristics potentially associated with “elderly frequent users”.Material and MethodsA retrospective study was performed during the calendar year 2014 (1st January 2014 – 31st December 2014) analyzing all ED admissions to the University Hospital of Rome Tor Vergata. Variables collected included age, triage code, arrival data, discharge diagnosis, and visit outcome. We performed a risk analysis using univariate binary logistic regression models.ResultsA total number of 38,016 patients accessed the ED, generating 46,820 accesses during the study period, with an average of 1.23 accesses for patient. The elderly population represented a quarter of the total ED population and had an increased risk of frequent use (OR 1.5: CI 1.4–1.7) and hospitalization (OR 3.8: CI 3.7–4). Moreover, they showed a greater diagnostic complexity, as demonstrated by the higher incidence of yellow and red priority codes compared to other ED populations (OR 3.1: CI 2.9–3.2).DiscussionOlder patients presented clinical and social characteristics related to the definition of “elderly frail frequent users”. The fact that a larger number of hospitalizations occurred in such patients is indirect evidence of frailty in this specific population, suggesting that hospital admissions may be an inappropriate response to frailty, especially when continued care is not established.ConclusionEnhancement of continuity of care, establishment of a tracking system for those who are at greater risk of visiting the ED and evaluating fragile individuals should be the highest priority in addressing ED frequent usage by the elderly.

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Section: Discussionmentioning

confidence: 99%

Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established

et al. 2016

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“…It included explaining to the patient the purpose and the course of the surgery, the need and the time of hospitalization, and the necessity for convalescence. Before these patients underwent cardiac surgery, they had undergone coronary angiography and been put on a waiting list, in a manner similar to that described by Ciccone et al 22 The waiting time before surgery can be used for appropriate education (with elements of psychiatry), preparing the patient for surgery in accordance with the model proposed by Ciccone et al, 23 and emphasizing the role of the nurse in improving QoL for patients with heart failure. McHugh et al 21 reported that training not only improved well-being and mood, but also resulted in a quantitative and qualitative reduction of CHD risk factors, such as smoking, body mass index, cholesterol concentrations, physical activity, and arterial blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Quality of life in elderly patients following coronary artery bypass grafting

Bąk¹,

Marcisz²

2014

PPA

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BackgroundSurgical revascularization of the coronary arteries leads to changes in quality of life (QoL) for patients with coronary heart disease. The aim of this work was to monitor QoL, considering cognitive function, depression, and activities of daily living in elderly patients after coronary artery bypass grafting (CABG).MethodsThis study included 65 patients (29 women and 36 men) aged 61–74 years with stable coronary heart disease who underwent CABG. The control group included 29 women and 36 men aged 61–74 years who were not suffering from coronary heart disease. The questionnaires used in the study canvassed QoL (Nottingham Health Profile), cognitive function, depression, and basic and instrumental activities of daily living. The research was conducted before surgery and repeated 6 and 12 months after surgery.ResultsQoL was comparable between women and men and was lower than in the control group (P<0.05). After CABG, the values for particular domains of QoL improved more in men than in women. There was a reduction in the severity of depression 6 months after surgery in men and 12 months after surgery in women.ConclusionElderly patients with coronary heart disease have decreased QoL, which normalizes in men and improves in women after CABG.

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“…During the follow-up, cardiologists and care managers should be in charge of the patient health and self-management. The proper partnership between the care manager and the patient may improve the long-term prognosis [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Thoracoscope-Assisted Mitral Valve Replacement with a Small Incision in the Right Chest: A Chinese Single Cardiac Center Experience

et al. 2018

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BackgroundThe aim of this study was to investigate the safety, feasibility, and clinical effectiveness of thoracoscopy-assisted mitral valve replacement via thoracic right-anterior minimal incision.Material/MethodsA retrospective analysis was conducted of 225 patients with mitral valve lesions who were treated in our hospital from August 2012 to August 2015. Group A included 105 patients undergoing thoracoscopy-assisted mitral valve replacement via a thoracic right-anterior minimal incision, and group B included 120 patients undergoing conventional mitral valve replacement. We collected and analyzed clinical data from both groups.ResultsThe procedures were successful in patients of both groups. No severe complications or mortality were reported. Postoperative mechanical ventilation time (8.6±2.4 h vs. 12.4±3.2 h), duration of intensive care (1.7±1.2 d vs. 2.8±1.3 d), duration of postoperative analgesia use (28.7±8.9 h vs. 36.3±7.5 h), postoperative length of hospital stay (8.2±2.2 d vs. 12.8±2.1 d), pleural fluid drainage (210.5±60.5 ml vs. 425.4±75.6 ml), blood transfusion amount (420.5±80.4 ml vs. 658.3±96.7 ml), and operative incision length (4.7±1.1 cm vs. 22.4±2.5 cm) were significantly shorter (or lower) in group A than in group B. There were different advantages and disadvantages in the 2 kinds of operative procedure in terms of postoperative complications.ConclusionsThoracoscopy-assisted mitral valve replacement via thoracic right-anterior minimal incision has the same clinical efficacy, safety, and feasibility as conventional mitral valve replacement.

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Waiting lists in coronary artery bypass graft patients and role of coronary angiography: the Apulian experience

Cited by 4 publications

References 7 publications

Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established

Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established

Quality of life in elderly patients following coronary artery bypass grafting

Thoracoscope-Assisted Mitral Valve Replacement with a Small Incision in the Right Chest: A Chinese Single Cardiac Center Experience

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