Coronary Artery Bypass Graft Surgery

Abstract

Although the literature is replete with evidence related to physiological predictors and short-term outcomes of coronary artery bypass graft (CABG) surgery, there is still a paucity of data that encompass a broader perspective of risk and outcomes. The primary objective of this prospective cohort study was to explore the physiological and psychosocial dimensions of preoperative status that may be predictive of the short- and longer term outcomes of CABG surgery. Patients (N = 136) scheduled for elective/urgent CABG surgery were followed from the time of placement on the waiting list until 6 months after the surgery. Significant predictors of intensive care unit length of stay (LOS) included the following: age, urgency of operation, and perioperative complications. Hospital LOS was best predicted by baseline unemployment, longer bypass time, and perioperative complications. Baseline unemployment and less optimism regarding surgery outcomes were predictive of postdischarge home care utilization. Lower baseline physical functioning predicted postdischarge emergency room visits. Sex and baseline mental status predicted quality of life/health satisfaction scores at 6 weeks and 6 months after discharge. The ability to predict patient outcomes has implications for program planning, patient education, and policy development. The findings of this study provide rationale for clinicians, educators, and administrators to consider a broader scope of physiological and psychosocial parameters to predict outcomes of CABG surgery. Although the sample size was relatively small, the broader perspective on risk and outcomes provides insight for strategies to optimize overall outcomes for the CABG surgery population. These findings also establish the cornerstone for ongoing CABG surgery outcomes evaluation and research.

Patients’ and partners’ health-related quality of life before and 4 months after coronary artery bypass grafting surgery

“…Previous studies have identified that patients’ pre-operative measurement of physical health and mental health predicts their HRQoL after CABG [7,9,10,12,13,24,26,40],[41]. Our study results concur with earlier research, and also highlight the interrelatedness of the physical and mental HRQoL components and so the importance of patient’s biopsychosocial assessment.…”

“…The differences in these findings may be due to the study designs, the populations studied and the HRQoL dimensions measured. Previous CABG studies have often used the 8 sub-scales of the SF-36 [21,26,39,40], which makes comparison of research difficult. Previous research suggests patients’ NYHA class correlates with mental health after CABG i.e.…”

Gender differences in recovery outcomes after an early recovery symptom management intervention

“…Consistent with findings by other researchers, 30,32,60-63 women in this study had a higher presence and burden of symptoms, as well as a lower level of physical activity, than men. Preoperative factors that may explain the gender discrepancy among women for outcomes after CABS include a higher number of comorbidities (eg, heart failure, hypertension, peripheral vascular disease, or diabetes), 64,65 more impaired functioning and cardiac condition before CABS, 3 and delays in treatment 66 attributable to atypical presentations of cardiac symptoms in women. 67 In contrast to these findings, women had a similar comorbidity profile at baseline compared with men, which did not support the assumption that higher comorbidity in women leads to their suboptimal CABS outcomes.…”

A Study to Assess the Effect of an IB (Information Bundle) on Physiological Parameters among Patients Undergoing Upper GI Endoscopy

“…It was found that the pre-operative anxiety is associated with high levels of anxiety, increase pain, changes in the physiological parameters and prolonged hospitalization. Anxiety can have a negative impact on the induction of the anesthesia, and recovery, as well as the low patient satisfaction with the perioperative interventions [6].…”