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Adherence to practice guidelines for coronary artery bypass graft surgery in Shiraz, Iran
Negar Darvish1, Mohammad Ali Ostovan2, Mehrdad Askarian3
1Resident, Department of Community Medicine, School of Medicine, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
Adherence to 2011 American College of Cardiology Foundation (ACCF) and American Heart Association (AHA) guidelines for coronary artery bypass graft (CABG) surgery was assessed. A significant portion of patients (10.2%) received inappropriate treatment, highlighting a need for improved guideline implementation.
Area of Science:
- Cardiology
- Evidence-Based Medicine
- Clinical Guidelines
Background:
- Physicians increasingly adopt evidence-based medicine (EBM) and clinical guidelines.
- Adherence to guidelines for coronary artery bypass graft (CABG) surgery is crucial for consistent patient care.
Purpose of the Study:
- To evaluate adherence to the 2011 American College of Cardiology Foundation (ACCF) and American Heart Association (AHA) guideline for CABG.
- To assess the appropriateness of CABG procedures based on established clinical guidelines.
Main Methods:
- A cross-sectional study involving 246 patients who underwent CABG between 2011-2012.
- Patients were classified according to the 2011 ACCF/AHA guideline into appropriate, inappropriate, or uncertain categories.
- Statistical analysis included Chi-square tests for categorical variables and t-tests for continuous variables.
Main Results:
- 82.9% of patients' CABG procedures were deemed appropriate.
- 10.2% of patients' CABG procedures were classified as inappropriate.
- 6.9% of cases were categorized as uncertain regarding guideline adherence.
Conclusions:
- Improved attention to ACCF/AHA guidelines for CABG is recommended.
- Consistent application of these guidelines can promote a standardized surgical approach for CABG patients.
Background:
There is an increasing tendency to use evidence-based medicine (EBM) and guidelines among physicians. This is also true for concordance of coronary artery bypass graft (CABG) surgery and guidelines; therefore, we aimed to address the adherence to 2011 American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) guideline for CABG.
Methods:
In this cross-sectional study, we assessed 246 patients who underwent CABG in Shiraz, Iran, during 2011-2012, using a data collecting form provided through studying ACCF/AHA guideline 2011. The patients were categorized into clinical subgroups and then grouped into appropriate, in-appropriate and uncertain classes. Chi-square was used to compare categorical variables and t-test was used for continuous variables.
Results:
Of the 246 patients, 70.3% were grouped into "class I," 12.6% into "class IIa," 6.9% into "class IIb" and 10.2% into "class III." Therefore, 82.9% of the patients were grouped into "appropriate," 6.9% into "uncertain," and 10.2% into group "inappropriate."
Conclusion:
We suggest that more attention is needed to be paid to these guidelines. Using these guidelines may help surgeons to have a uniform approach for patients.
