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Published on: March 27, 2018
Risk factors for decreased cardiac output after coronary artery bypass grafting: a prospective cohort study
Eduarda Ribeiro Dos Santos1,2, Camila Takao Lopes1, Vera Lucia Regina Maria1,3
11 Paulista Nursing School, Federal University of São Paulo (EPE-UNIFESP), Brazil.
Insights
This study identified key risk factors for decreased cardiac output after coronary artery bypass grafting (CABG). Age over 60, reduced ejection fraction, and post-operative arrhythmia are significant predictors.
Area of Science:
- Cardiovascular Surgery
- Nursing Diagnosis
- Postoperative Care
Background:
- No prior research identified risk factors for decreased cardiac output post-coronary artery bypass grafting (CABG).
- Understanding these predictors is crucial for effective nursing interventions.
Purpose of the Study:
- To identify predictive risk factors for the nursing diagnosis of risk for decreased cardiac output following CABG.
- To enhance patient monitoring and care strategies in the immediate postoperative period.
Main Methods:
- Prospective cohort study involving 257 adult patients undergoing CABG.
- Analysis of medical records to identify potential risk factors.
- Univariate analysis, logistic regression, and Fisher's exact test were employed.
Main Results:
- 195 patients experienced decreased cardiac output post-CABG.
- Predictive factors include age (⩾60 years), reduced left ventricle ejection fraction, non-use of radial artery graft, positive fluid balance, and altered postoperative arrhythmia.
- The model demonstrated 81.5% accuracy.
Conclusions:
- Identified predictive risk factors for decreased cardiac output after CABG.
- Findings can guide nurses in patient monitoring, staff training, and resource allocation.
- Improves proactive nursing care for high-risk patients.
Background:
No previous study has investigated the predictive risk factors of the nursing diagnosis of risk for decreased cardiac output after coronary artery bypass grafting (CABG).
Aims:
This study aimed to identify the predictive risk factors of the nursing diagnosis of risk for decreased cardiac output after CABG.
Methods:
This was a prospective cohort study performed at a cardiac university hospital in São Paulo, Brazil and 257 adult patients undergoing CABG were included. Potential risk factors for low cardiac output in the immediate post-operative period were investigated using the patients' medical records. Univariate analysis and logistic regression were used to identify the predictive risk factors of decreased cardiac output. The area under the receiver operating characteristic curve was calculated as a measure of accuracy. The variables that could not be analysed through logistic regression were analysed through Fisher's exact test.
Results:
One hundred and ninety-five patients had low cardiac output in the immediate post-operative period. The predictive risk factors included age ⩾60 years, decreased left ventricle ejection fraction, not using the radial artery graft, positive fluid balance and post-operative arrhythmia that differed from the pre-operative arrhythmia. This model predicted the outcome with a sensitivity of 62.9%, a specificity of 87.2% and an accuracy of 81.5%. The variables analysed through Fisher's exact test included heart failure, re-exploration and bleeding-related re-exploration.
Conclusions:
The predictive risk factors for the nursing diagnosis of risk for decreased cardiac output after CABG were found. These results can be used to direct nurses in patient monitoring, staff training and nursing team staffing.
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