冠状动脉搭桥术后再入院的危险因素:一项病例对照研究

IF 0.7 Q4 NURSING Nursing Practice Today Pub Date : 2020-07-22 DOI:10.18502/npt.v7i4.4039
Elham Alimadadi, M. Abbasinia, A. Mohammadbeigi, Mohammad Abbasi
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引用次数: 4

摘要

背景与目的:减少再次入院是医疗保健系统的主要目标。本研究旨在确定冠状动脉搭桥术后再次入院的危险因素。方法与材料:这项病例对照研究分析了2016年1月至2019年12月在伊朗库姆Shahid Beheshti医院接受冠状动脉搭桥手术的540名患者。病例组包括出院后30天内再次入院的270名患者,对照组包括270名未再次入院的患者。结果:再次入院的患者心力衰竭、心肌梗死、高血压、心肌心律失常和使用抗血小板凝血药物的发生率较高(P<0.05)。与未再次入院患者相比,再次入院患者更有可能进行紧急手术(OR 1.62;CI 1.11-2.38)、心脏骤停(OR 2.52;CI 2.39-2.85),术中大量出血(OR 2.36;CI 2.13-2.67)。术后疾病如手术部位感染、胸腔积液、心律失常和心肌梗死是再次入院的独立危险因素(P<0.05)。结论:应密切监测有再次入院风险的患者。此外,多学科团队对手术标准的谨慎决策有助于改善结果并减少再次入院。
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Risk factors of readmission after coronary artery bypass graft surgery: A case-control study
Background & Aim: Reducing readmissions is a major goal of health care systems. This study aimed to identify readmission risk factors following coronary artery bypass graft surgery. Methods & Materials: This case-control study analyzed 540 patients who underwent coronary artery bypass graft surgery between January 2016 and December 2019 at Shahid Beheshti Hospital in Qom, Iran. The case group contained 270 patients who were readmitted to the hospital during the 30-day after discharge and the control group comprised 270 non-readmitted patients. Results: Readmit patients suffered from higher rates of cardiac failure, myocardial infarction, hypertension, myocardial dysrhythmia, and using antiplatelet coagulant medication (P<0.05). Compared with non-readmitted patients, readmitted patients were more likely to have emergency surgery (OR 1.62; CI 1.11-2.38), cardiac arrest (OR 2.52; CI 2.39-2.85), and massive intraoperative hemorrhage during surgery (OR 2.36; CI 2.13-2.67). Postoperative disorders such as surgical site infection, pleural effusion, dysrhythmias, and myocardial infarction were independent risk factors for readmission (P<0.05). Conclusion: Patients at risk for readmission should be closely monitored. Furthermore, careful decision-making about surgical criteria by a multidisciplinary team can help improve outcomes as well as reduce readmissions.
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来源期刊
Nursing Practice Today
Nursing Practice Today Nursing-Nursing (all)
CiteScore
1.80
自引率
0.00%
发文量
20
审稿时长
12 weeks
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