Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 1 de 1
Filter
Add more filters










Database
Language
Publication year range
1.
J Cardiothorac Surg ; 14(1): 64, 2019 Apr 02.
Article in English | MEDLINE | ID: mdl-30940172

ABSTRACT

BACKGROUND: Bleeding is a significant complication in cardiac surgery and is associated with substantial morbidity and mortality. This study evaluated the impact of bleeding on length of stay (LOS) and critical care utilization in a nationwide sample of cardiac surgery patients treated at English hospitals. METHODS: Retrospective, observational cohort study using linked English Hospital Episode Statistics (HES) and Clinical Practice Research Datalink (CPRD) records for a nationwide sample of patients aged ≥18 years who underwent coronary artery bypass graft (CABG), valve repair/replacement, or aortic operations from January 2010 through February 2016. The primary independent variables were in-hospital bleeding complications and reoperation for bleeding before discharge. Generalized linear models were used to quantify the adjusted mean incremental difference [MID] in post-procedure LOS and critical care days associated with bleeding complications, independent of measured baseline characteristics. RESULTS: The study included 7774 cardiac surgery patients (3963 CABG; 2363 valve replacement/repair; 160 aortic procedures; 1288 multiple procedures, primarily CABG+valve). Mean LOS was 10.7d, including a mean of 4.2d in critical care. Incidences of in-hospital bleeding complications and reoperation for bleeding were 6.7 and 0.3%, respectively. Patients with bleeding had longer LOS (MID: 3.1d; p < 0.0001) and spent more days in critical care (MID: 2.4d; p < 0.0001). Reoperation for bleeding was associated with larger increases in LOS (MID = 4.0d; p = 0.002) and days in critical care (MID = 3.2d; p = 0.001). CONCLUSIONS: Among English cardiac surgery patients, in-hospital bleeding complications were associated with substantial increases in healthcare utilization. Increased use of evidence-based strategies to prevent and manage bleeding may reduce the clinical and economic burden associated with bleeding complications in cardiac surgery.


Subject(s)
Blood Loss, Surgical/statistics & numerical data , Cardiac Surgical Procedures/adverse effects , Critical Care/statistics & numerical data , Length of Stay/statistics & numerical data , Postoperative Hemorrhage/epidemiology , Adolescent , Adult , Aged , Cardiac Surgical Procedures/mortality , Databases, Factual , England/epidemiology , Female , Hemorrhage/epidemiology , Hemorrhage/etiology , Hemorrhage/surgery , Hospital Mortality , Humans , Incidence , Male , Middle Aged , Postoperative Hemorrhage/etiology , Postoperative Hemorrhage/mortality , Postoperative Hemorrhage/surgery , Reoperation , Retrospective Studies , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL
...