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Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Predicting Length of Stay in Jordanian Patients Undergoing Isolated Coronary Artery Bypass Graft: Insights From a
Al-A'mar Farah1, Al-Amer Rasmieh2, Saleh Y N Mohammad3
1Al-Zaytoonah University, Faculty of Nursing, Amman, Jordan.
Insights
This study found that acute kidney injury, atrial fibrillation, bleeding, and prolonged chest tube use increase length of stay (LOS) for cardiac surgery patients. Fresh frozen plasma transfusion and private hospital care were associated with shorter LOS.
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Health Services Research
Background:
- Length of stay (LOS) in critical care units significantly impacts patient outcomes, nursing workload, and resource utilization.
- Understanding factors influencing LOS is crucial for optimizing patient care and resource management in intensive care settings.
Purpose of the Study:
- To determine the average length of stay (LOS) for patients undergoing Coronary Artery Bypass Grafting (CABG) surgery in Jordan.
- To identify demographic, clinical, and treatment-related factors associated with LOS among CABG patients in Jordanian critical care units.
Main Methods:
- A prospective observational study involving 172 CABG patients was conducted across nine Jordanian medical centers from January to July 2023.
- Data were collected using a validated questionnaire and medical records, encompassing pre-, intra-, and postoperative factors.
- Convenience sampling was employed for patient selection.
Main Results:
- The average LOS for CABG patients was 3.8 days (SD ±2).
- Factors significantly predicting increased LOS included acute kidney injury, atrial fibrillation, bleeding, and prolonged chest tube duration.
- Intraoperative fresh frozen plasma transfusion and treatment in private hospitals were associated with a reduced LOS.
Conclusions:
- Identifying predictors of LOS is essential for critical care nursing to enhance patient management and recovery.
- Developing standardized, evidence-based CABG management protocols and optimizing transfusion strategies can improve patient outcomes and nursing efficiency.
- Targeted nursing interventions addressing complications and delays can shorten LOS and reduce the burden on critical care resources.
Background:
The length of stay (LOS) in critical care units greatly influences patient outcomes, nursing responsibilities and resource use.
Aim:
This study aimed to identify the average LOS among CABG patients and the factors associated with LOS among CABG patients in critical care units in Jordan.
Study Design:
A prospective observational study was conducted across nine Jordanian medical centres between January and July 2023. The study sample was selected through convenience sampling. Data regarding demographics, clinical characteristics, and pre-, intra- and postoperative factors were gathered using a validated questionnaire and medical records.
Results:
This study recruited 172 patients undergoing CABG. The average age of participants was 57.86 years (SD ±9.5). The most common comorbidities were hypertension (73.3%) and hyperlipidaemia (69.2%), while the most frequent postoperative complication was electrolyte imbalance (42.4%). The average length of stay (LOS) was 3.8 days (SD ±2). Key factors predicting an increased LOS included acute kidney injury (β = 4.7, p = 0.002), atrial fibrillation (β = 1.82, p < 0.05), bleeding (β = 1.35, p < 0.05) and long chest tube duration (β = 2.78, p < 0.05). In contrast, intraoperative fresh frozen plasma transfusion (β = -1.68, p = 0.050) and treatment in private hospitals (β = -2.5, p = 0.010) were associated with reduced LOS.
Conclusion:
Identifying the predictors of LOS is crucial for critical care nursing to improve patient management and facilitate recovery. Targeted nursing actions to address complications and minimise delays can enhance outcomes, shorten LOS and lessen the burden on resources in critical care settings.
Relevance To Clinical Practice:
Our study highlighted the lack of standardised, evidence-based CABG management protocols. Hence, health policymakers, healthcare professionals and nursing leaders are invited to develop practical guidelines that may enhance both patient outcomes and nursing efficiency in critical care settings. Additionally, this study identified fresh frozen plasma (FFP) transfusion as a key factor in reducing the length of stay. Thus, optimising transfusion protocols may enhance recovery, minimise complications, streamline nursing workflows, reduce the ICU burden and improve overall care delivery.
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