BACKGROUND: Rising healthcare costs have prompted limitations in the length of stay (LOS) for patients undergoing coronary artery bypass graft surgery (CABG). Because not all patients are candidates for early discharge, in the present study our aim was to determine factors that prolong LOS. METHODS AND RESULTS: In 194 consecutive patients undergoing CABG procedures, LOS was > 7 days in 37%. Stepwise multiple regression procedures and chi 2 testing were used to determine what factors prolonged LOS for > 7 days. Preoperative factors that significantly (P < .05) prolonged LOS included repeat CABG, CABG plus valve surgery, congestive heart failure, preoperative coronary care unit stay, renal failure, and insulin-dependent diabetes mellitus. Patients with at least one risk factor had a significantly higher incidence of LOS of > 7 days (47% versus 17%; P < .001). Significant (P < .05) postoperative factors prolonging LOS included arrhythmias, respiratory insufficiency, pneumonia, and wound infection. Of patients with at least one risk factor, 83% had LOS of > 7 days (P < .001). CONCLUSIONS: The presence of certain preoperative and post-operative risk factors can be predicted to prolong LOS after CABG surgery. This should be taken into consideration when defining reimbursement policies.
BACKGROUND: Rising healthcare costs have prompted limitations in the length of stay (LOS) for patients undergoing coronary artery bypass graft surgery (CABG). Because not all patients are candidates for early discharge, in the present study our aim was to determine factors that prolong LOS. METHODS AND RESULTS: In 194 consecutive patients undergoing CABG procedures, LOS was > 7 days in 37%. Stepwise multiple regression procedures and chi 2 testing were used to determine what factors prolonged LOS for > 7 days. Preoperative factors that significantly (P < .05) prolonged LOS included repeat CABG, CABG plus valve surgery, congestive heart failure, preoperative coronary care unit stay, renal failure, and insulin-dependent diabetes mellitus. Patients with at least one risk factor had a significantly higher incidence of LOS of > 7 days (47% versus 17%; P < .001). Significant (P < .05) postoperative factors prolonging LOS included arrhythmias, respiratory insufficiency, pneumonia, and wound infection. Of patients with at least one risk factor, 83% had LOS of > 7 days (P < .001). CONCLUSIONS: The presence of certain preoperative and post-operative risk factors can be predicted to prolong LOS after CABG surgery. This should be taken into consideration when defining reimbursement policies.
Authors: Maria Tafelmeier; Teresa Weizenegger; Sarah Ripfel; Miriam Fauser; Bernhard Floerchinger; Daniele Camboni; York Zausig; Sigrid Wittmann; Marzena A Drzymalski; Florian Zeman; Christof Schmid; Lars S Maier; Stefan Wagner; Michael Arzt Journal: Clin Res Cardiol Date: 2018-06-12 Impact factor: 5.460
Authors: Christian Stoppe; Andreas Goetzenich; Glenn Whitman; Rika Ohkuma; Trish Brown; Roupen Hatzakorzian; Arnold Kristof; Patrick Meybohm; Jefferey Mechanick; Adam Evans; Daniel Yeh; Bernard McDonald; Michael Chourdakis; Philip Jones; Richard Barton; Ravi Tripathi; Gunnar Elke; Oliver Liakopoulos; Ravi Agarwala; Vladimir Lomivorotov; Ekaterina Nesterova; Gernot Marx; Carina Benstoem; Margot Lemieux; Daren K Heyland Journal: Crit Care Date: 2017-06-05 Impact factor: 9.097