An Investigation of the Variables Associated with Normal and Delayed Hospital Discharge following First Time Isolated Coronary Artery Bypass Graft Surgery

Abstract

The optimum day for discharge after coronary artery bypass graft (CABG) surgery has been subject to some debate yet there has been a steady increase in the number of patients discharged within 5 days of surgery. Delayed discharges may result in the under use of surgical capacity and impact upon patient outcomes.

The author conducted a retrospective; correlational study of 333 patients to investigate the variables associated with delayed discharge after CABG. The results suggest it is possible to identify patients likely to achieve a 5-day discharge from their age and Parsonnet score [Circulation, 79(Suppl. I), 1989, 3.]. The introduction of a policy of adopting a 5-day discharge for those patients could maximise surgical capacity and improve patient outcomes. Further prospective study is recommended after the policy has been implemented to evaluate the effectiveness of age and Parsonnet score to predict a 5-day discharge.

Keywords

normal discharge delayed discharge coronary artery bypass graft surgery age Parsonnet score

Get full access to this article

View all access options for this article.

References

Parsonnet

, Dean

and Bernstein

A. D.

A method of uniform stratification of risk for evaluating the results of surgery in acquired heart disease. Circulation, 1989, 79(Suppl. I), 3–12.

American College of Cardiology/American Heart Association Guidelines and indications for coronary artery bypass graft surgery. A report of the American College of Cardiology/American Heart Association Task Force on assessment of diagnostic and therapeutic cardiovascular procedures (Subcommittee on Coronary Artery Bypass Graft Surgery). Journal of the American College of Cardiology, 1991, 17, 543–589.

Keogh

B. E.

and Kinsman

National Adult Cardiac Surgical Database Report, 1998. Society of Cardiothoracic Surgeons of Great Britain and Ireland, UK, 1999.

Lazar

H. L.

, Wilcox

, McCormick

J. R.

Determinants of discharge following coronary artery bypass surgery. Chest, 1987, 92, 800–803.

Sanchez

, Jacob

and Newark

N. J.

Temporal relationship of complications after coronary artery bypass surgery: scheduling for safe discharge. American Heart Journal, 1994, 127, 282–286.

Birdi

, Izzat

M. B.

, Angelini

G. D.

In-hospital audit underestimates early post-operative morbidity after cardiac surgery. British Heart Journal, 1995, 74, 556–558.

Rudisill

, Philips

and Payne

Clinical paths for cardiac surgery patients; a multidisciplinary approach to quality improvement outcomes. Journal of Nursing Care Quality, 1994, 8 (3), 27–33.

Mounsey

J. P.

, Griffith

M. J.

, Heaviside

D. W.

Determinants of length of stay in intensive care and in hospital after coronary artery surgery. British Heart Journal, 1995, 73, 92–98.

Katz

N. M.

, Ahmed

S. W.

, Clark

B. K.

Predictors of length of hospitalisation after cardiac surgery. Annals of Thoracic Surgery, 1988, 45, 656–660.

10.

Weintraub

W. S.

, Jones

E. L.

, Craver

Determinants of prolonged hospital stay after coronary bypass surgery. Circulation, 1989, 8 (2), 276–284.

11.

Naughton

, Prowroznyk

and Feneck

Reasons for prolonged hospital stays following heart surgery. British Journal of Nursing, 1999, 8 (16), 1085–1094.

12.

Sternlieb

J. J.

Exploring the risk of early dismissal following cardiac operations. Journal of Cardiovascular Surgery, 1987, 28, 120–123.

13.

Riddle

M. M.

, Dunstan

J. L.

and Castanis

J. L.

A rapid recovery program for cardiac surgery patients. American Journal of Critical Care, 1996, 5 (2), 152–159.

14.

Cotton

Fast-track improves CABG outcomes. Journal of the American Medical Association, 1993, 270, 2022.

15.

Krohn

B. G.

, Kay

J. H.

, Mendez

M. A.

Rapid sustained recovery after cardiac operations. Journal of Thoracic Cardiovascular Surgery, 1990, 100, 194–197.

16.

Roberts

A. J.

, Woodhall

D. D.

, Conti

C. R.

Mortality, morbidity, and cost-accounting related to coronary artery bypass graft surgery in the elderly. Annals of Thoracic Surgery, 1985, 39, 426–432.