Comparing outcomes of patients submitted to coronary artery bypass graft surgery accompanied in a general or cardiac Intensive Care Unit

Abstract

Background: Cardiovascular diseases are the main cause of death and loss of quality of life in the long term. In the USA, cardiac surgeries represent the most performed surgery category, with an average cost of USD 40,000. Because it is a complex procedure and leads the patient to a critical post-operative state, there is a necessity of intensive care.Objective: Compare the health indicators of patients submitted to postoperative myocardial revascularization surgery when they are in a general Intensive Care Unit (GICU) or in a cardiac Intensive Care Unit (CICU) in a Brazilian institution.Methods: This is a quantitative, retrospective, descriptive study of patients submitted to a coronary artery bypass grafting surgery in a hospital of high complexity. Data were collected from the medical records and grouped into two phases. Phase 1 is the pre-implantation of the CICU, with a total of 50 patients, in a period in which the postoperative of myocardial revascularization surgeries were performed in the GICU. The second phase corresponds to the postoperative period performed in the CICU, with a total of 60 patients.Results: Males were predominant in the study, with the mean age being over 60 years. The most frequent comorbidities in the two groups were systemic arterial hypertension, dyslipidemias and type 2 diabetes mellitus. The main postoperative complications were surgical site infections, cardiac arrhythmias and pleural effusion. After the implementation of the specialized ICU, there was a reduction in the total hospitalization time and a reduction in cost by day and total cost of hospitalization.Conclusions: The specialized ICU promoted a reduction in the total hospitalization time of patients submitted to coronary artery bypass grafting surgeries and a reduction in hospital costs for the Brazilian public health service, facts that demonstrate the importance of these specialized services in high complexity hospitals.