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Determinants of time to discharge following coronary artery by pass grafting
J Herlitz1, G Brandrup, H Emanuelsson
1Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Insights
Predictors of longer hospital stays after coronary artery bypass grafting (CABG) include age, female sex, and pre-existing conditions. Understanding these factors can help manage patient recovery times post-CABG surgery.
Area of Science:
- Cardiology
- Thoracic Surgery
- Health Services Research
Background:
- Coronary artery bypass grafting (CABG) is a common surgical procedure.
- Hospital length of stay (LOS) after CABG can vary significantly.
- Identifying factors influencing LOS is crucial for resource management and patient care.
Purpose of the Study:
- To identify clinical factors before and during coronary artery bypass grafting (CABG) that are associated with the duration of hospital stay until discharge.
Main Methods:
- A retrospective study was conducted on 2035 patients who underwent CABG without simultaneous valve surgery in western Sweden between June 1, 1988, and June 1, 1991.
- The time from operation to hospital discharge was calculated for each patient.
- Various pre-, peri-, and postoperative factors were analyzed to determine their association with hospital discharge time.
Main Results:
- The median time from operation to discharge for patients discharged alive was 15 days, with a range of 2 to 191 days.
- Independent predictors for a longer hospital stay included advanced age, female sex, prolonged time in respirator, previous congestive heart failure, reoperation, neurological complications, elevated serum aspartate aminotransferase, pneumo/hydrothorax, prior cerebrovascular disease, non-smoker status, supraventricular arrhythmia, extended intensive care unit stay, longer aortic cross-clamp time, and obesity.
Conclusions:
- A significant number of pre- and postoperative factors are associated with increased hospital length of stay after CABG.
- These findings highlight the complexity of patient recovery trajectories following CABG surgery.
Aim:
To describe clinical factors prior to and at the time of coronary artery bypass grafting (CABG) associated with the number of days until hospital discharge.
Patients:
All patients from western Sweden in whom during the time period June 1 1988-June 1 1991 CABG was performed without simultaneous valve surgery.
Methods:
The time between operation and hospital discharge was calculated for every patient and related to various factors prior to and at the operation.
Results:
Among 2035 patients the time between operation and discharged alive from hospital varied between 2 and 191 days (median 15 days). When simultaneously considering pre-, per- and postoperative factors the following appeared as independent predictors for a longer hospital time: age (years) (P < 0.0001); female sex, (P < 0.0001); time in respirator (P = 0.0004); previous congestive heart failure (P = 0.0007); reoperation (P = 0.0008); neurological complication (P = 0.001); maximum activity of serum aspartate amino transferase (P = 0.002); pneumo/hydrothorax (P = 0.002), previous cerebrovascular disease (P = 0.004), non-smoker (P = 0.006); supraventricular arrhythmia (0.006); time in intensive care unit (P = 0.007); aortic cross-clamp time (P = 0.009); obesity (P = 0.02).
Conclusion:
A large number of pre- and postoperative factors are associated with an increased time between operation and time to discharge.