Circulation, Vol 80, 276-284, Copyright © 1989 by American Heart Association
WS Weintraub, EL Jones, J Craver, R Guyton and C Cohen
The length of hospital stay after coronary surgery was studied in 4,683
patients undergoing cardiac catheterization followed by coronary surgery at
Emory University Hospital or Crawford Long Hospital between the years 1981
and 1986. Length of stay after coronary surgery had a median and modal
value of 7 days. There was, however, a long statistical tail of patients
with a prolonged length of stay extending out to more than 180 days.
Prolonged length of stay (greater than 10 days) could be correlated with
preprocedural variables such as age, elective versus emergency status,
angina class, ejection fraction, and gender. Length of stay increased from
a mean of 6.9 +/- 1.4 days under the age of 40 years to 10.9 +/- 12.1 days
over the age of 70 years (p less than 0.0001). Length of stay was
correlated with the periprocedural variables of wound infection, neurologic
event, arrhythmias, pneumonia, postoperative myocardial infarction,
mortality, and pericarditis. Length of stay increased from 8.8 +/- 9.6 days
without a neurologic event to 21.1 +/- 17.9 days with a neurologic event (p
less than 0.0001). Similarly, without a wound infection, the average stay
was 8.7 +/- 8.9 days; with a wound infection, the average stay was 32.2 +/-
25.8 days (p less than 0.0001). The correlates of prolonged stay were
tested in another population comprising 781 patients undergoing cardiac
catheterization followed by coronary artery bypass grafting in 1987. The
predictors of prolonged stay in the 1987 population were wound infection,
pneumonia, arrhythmias, age, neurologic events, postoperative infarction,
and ejection fraction. Thus, length of hospital stay after coronary surgery
may be predicted by multiple preprocedural and periprocedural
variables.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Determinants of prolonged length of hospital stay after coronary bypass surgery
Division of Cardiology, Emory University Hospital, Atlanta, GA 30322.
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