635 Cost-Effectiveness of a Heart Failure Nurse Practitioner Service for Patients Hospitalised With Acute Heart Failure

Abstract

Background: It remains unclear whether obesity, measured by body mass index (BMI) is an independent risk factor of morbidity and mortality after coronary artery bypass grafting (CABG). We sought to determine whether body fat distribution, measured by waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) is a better predictor of postoperative complications after CABG than BMI. Methods: 2,062 patients who underwent isolated elective on-pump CABG with documented BMI were identified from the ANZSCTS database (2010-2019) at St Vincent's Hospital, Melbourne. Our primary analysis assessed the relationship between BMI and postoperative complications using multivariable logistic regression. Secondary analysis included only those patients with recorded waist and hip circumferences (n=640). WHR, WC and HC were compared with incidence of postoperative complications in multivariate analyses. Results: BMI was associated with an increased risk of new renal failure (OR 1.08, p,0.00). Increasing WHR significantly increased the risk of prolonged intubation in females (OR 1.12, p,0.01). In males, both WC and HC were significantly associated with increased risks of new renal failure (OR 1.06, p,0.00; OR 1.07, p,0.00) and ICU readmission (OR 1.05, p,0.01; OR 1.04, p,0.04). Conclusion: WC, HC and WHR may be useful screening tools in identifying patients at risk of postoperative complications. This study is one of the first to consider these alternative anthropometric measures to BMI in predicting postoperative outcomes following CABG.

Nurse practitioner work patterns: A cross‐sectional study

“…The Australian NP role has consistently demonstrated improved patient outcomes (Driscoll et al., 2016; Fong et al., 2017; Lowe et al., 2011;), high levels of patient satisfaction (Carter et al., 2015; Fox et al., 2017) and deliver safe, high quality care (Tori, 2020) and is cost‐effective (Driscoll et al., 2019). The Australian NP role addresses the shortage of health practitioners in several specialist, acute areas and is evolving to lead integrated services in primary healthcare environments in rural communities (Barraclough et al., (2016).…”