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ANALYSES OF DEMOGRAPHIC CHANGES AND OUTCOME IN TERTIARY CARDIAC SURGERY PRACTICE FROM 1991-1999

Institution. Hamilton General Hospital, McMaster University. Hamilton Ontario

BACKGROUND

Many changes in the practice of Cardiac Anesthesia, Surgery, and Critical Care have been introduced over the past decade. Rising healthcare costs have promoted physicians and third party payers to initiate fast-tracking programme to limit the length of stay in intensive care unit after cardiac surgical procedures.(1) A fast-tracking programme was initiated in our institution in 1995. Studies have documented an increase in the mean age of patients undergoing cardiac surgery. The purpose of our study is to review the changes in surgical population and outcome over a nine year period. Outcome is defined as ICU length of ventilation (LOV), length of stay (LOS), and mortality.

METHODS

The study population comprises 9,727 patients who had cardiac surgery from 1991 to 1999. Data including basic demographics and outcome were concurrently collected by a dedicated individual as part of the Critical Care quality assurance program. Data collected for this analyses from the database included age, hypertension, ICU LOS, LOV, and mortality. Data that were incomplete were excluded from the analyses. For purpose of analyses of change over time, patient data were organized into one year time blocks and devided into nine groups determined by admission date to ICU from 1991 to 1999. Patients in the nine group were compared by use of Chitest for categorical variables and ANOVA procedures for continuous variables. The alpha level of significance was established as .05 for the overall nine group comparions. All statistical analyses were performed with segma statistical software.

RESULTS

The total number of patients in this study was 9,727. 146 patients were exclude from the study due to invalid data input. Significant changes in group characteristics were noted in the eight time periods (table 1) with patient age significantly increasing over time. The greatest change occurred between group I - VII and group VIII & IX. No significant change between the mean age of group VIII and group IX.

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The LOS was significantly reduce over time in group V, VI, VII, VIII and X compare to group I, II, III and IV. The introduction of fast-tracking programme which was initiated in our institution on 1995 has decreased the LOS. In this study LOS was directly proportional with the LOV. The mortality rate was not significantly changed over the time period despite increasing age.

REFERENCES

1 Circulation 1995;92[suppl II]: II-20 -II-24

2 Circulation 1997 Sep 2;96(5):1575-9[Abstract/Free Full Text]

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fayad, A.A. Articles by Sawchuk, C. Search for Related Content PubMed Articles by Fayad, A.A. Articles by Sawchuk, C.