Relationship between Selected Factors and Length of Hospital Stay in Coronary Artery Bypass Graft Patients

Authors

  • Ketsarin Utriyaprasit Department of Surgical Nursing, Faculty of Nursing, Mahidol University, Bangkok 10700
  • Pornnapa Hengcharoensuwan Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Siriorn Sindhu Department of Surgical Nursing, Faculty of Nursing, Mahidol University, Bangkok 10700
  • Pansak Laksanabunsong Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700

Keywords:

Length of hospital stay; psychological factors; coronary artery bypass graft

Abstract

Objective: One of the health outcomes indicating the quality of care is the length of hospital stay. This descriptive research aimed to examine the associations between psychological factors (mood state), operative factors (cardiopulmonary bypass (CPB) time, type of surgery) and post-operative length of hospital stay (LOS) in coronary artery bypass graft (CABG) patients.
Methods: A convenient sample of 109 coronary artery disease (CAD) patients admitted to a university hospital in central Thailand to have elective CABG surgery for the first time were approached. Data were collected by using a socio-demographic and clinical profile with the Profile of Mood State Brief-Thai (POMS-B Thai). Data were analyzed using Pearsonัs Product
Moment Correlation and Spearmanัs Rank Correlation Coefficient to answer the research questions.
Results: The majority of the participants were males with an average age of 63.1 ± 9.5 years. The postoperative LOS ranged from 4 to 15 days with the average being 7.3 days. The total mood disturbance score averaged 10.5 points. The most common negative mood states were confusion and anxiety. The majority of the patients had only CABG surgery with an
average CPB time of 89.9 minutes (SD 40.1). The significant factors associated with post-operative length of hospital stay were type of surgery and CPB time, while mood state was not found to be significantly related to LOS.
Conclusion: In order to promote patientsั recovery by shortening LOS, a rehabilitation program established by a health care team should be tailored specifically for the type of surgery and CPB time following CABG surgery.

References

1. World Health Organization. Cardiovascular diseases (CVDs) [cited 2009,31 December] Available from/http://www.who.int/topics/cardiovasculardisease/
en/.
2. Artinian NT, Duggan CH. Sex differences in patient recovery patterns after coronary artery bypass surgery. Heart Lung. 1995 Nov-Dec;24(6):483-94.
3. Utriyaprasit K, Moore SM. Recovery symptoms and mood states in Thai CABG patients. J Transcult Nurs. 2005 Apr;16(2):97-106.
4. Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, Cardiothoracic Surgery Annual Report, 2010. p. 13.
5. Herlitz J, Brandrup G, Emanuelsson H, Haglid M, Karlsson T, Karlson BW, et al. Determinants of time to discharge following coronary artery
bypass grafting. Eur J Cardiothorac Surg. 1997 Mar;11(3):533-8.
6. Peterson ED, Coombs LP, Ferguson TB, Shroyer AL, DeLong ER, Grover FL, et al. Hospital variability in length of stay after coronary artery bypass
surgery: Results from the society of thoracic surgeonัs national cardiac database. Ann Thorac Surg. 2002 Aug;74(2):464-73.
7. Welsby IJ, Bennett-Guerrero E, Atwell D, White WD, Newman MF, Smith PK, et al. The association of complication type with mortality and prolonged stay after cardiac surgery with cardiopulmonary bypass. Anesth Analg. 2002 May;94(5):1072-8.
8. Holzemer WL. The impact of nursing care in Latin America and the Caribbean: A focus on outcomes. J Adv Nurs. 1994 Jul;20(1):5-12.
9. Mardis R, Brownson K. Length of stay at an all-time low. Health Care Manag (Frederick). 2003 Apr-Jun;22(2):122-7.
10. Martin S, Smith P. Explaining variations in inpatient length of stay in the National Health Service. J Health Econ. 1996 Jun;15(3):279-304.
11. Rosen AB, Humphries JO, Muhlbaier LH, Kiefe CI, Kresowik T, Peterson ED. Effect of clinical factors on length of stay after coronary artery
bypass surgery: Results of the cooperative cardiovascular project. Am Heart J. 1999 Jul;138(1 Pt 1):69-77.
12. Whitman GR. Nursing-sensitive outcomes in cardiac surgery patients. J Cardiovasc Nurs. 2004 Sep-Oct;19(5):293-8.
13. Halpin LS, Barnett SD. Preoperative state of mind among patients undergoing CABG: effect on length of stay and postoperative complications.
J Nurs Care Qual. 2005 Jan-Mar;20(1):73-80.
14. Oxlad M, Stubberfield J, Stuklis R, Edwards J, Wade TD. Psychological risk factors for increased post-operative length of hospital stay following
coronary artery bypass graft surgery. J Behav Med. 2006 Apr;29(2):179-90.
15. Carney RM, Freedland KE, Rich MW, Jaffe AS. Depression as a risk factor for cardiac events in established coronary heart disease: A review of possible mechanisms. Ann Behav Med. 1995 Spring;17(2):142-9.
16. Edmunds LH Jr. Inflammatory response to cardiopulmonary bypass. Ann Thorac Surg. 1998 Nov;66(5 Suppl):S12-6.
17. Wan S, LeClerc JL, Vincent JL. Inflammatory response to cardiopulmonary bypass mechanisms involved and possible therapeutic strategies.
Chest. 1997 Sep;112(3):676-92.
18. Lazar HL, Fitzgerald C, Gross S, Heeren T, Aldea GS, Shemin RJ. Determinants of length of stay after coronary artery bypass graft surgery.
Circulation. 1995 Nov 1;92(9 Suppl):II20-4.
19. Polit DF, Beck CT. Nursing Research: Generating and assessing evidence for nursing practice. 8th ed. Philadelphia: Lippincott; 2008.
20. McNair DM, Lorr M, Droppleman LF. Manual: Profile of Mood State. San Diego, CA: Educational and industrial testing service; 1992.
21. Rymaszewska J, Kiejna A, Hadrys T. Depression and anxiety in coronary artery bypass grafting patients. Eur Psychiatry. 2003 Jun;18(4):155-60.
22. Chatburoot P. Surgical management of coronary artery disease Kantaratanakul V, Kulchorn na Ayudthaya T [Cardiac rehabilitation] Apisala
Intergroup, 2005. p. 61-74. [Thai]
23. Thourani VH, Weintraub WS, Craver JM, Jones EL, Gott JP, Brown WM 3rd, et al. Influence of concomitant CABG and urgent/emergent status
on mitral valve replacement surgery. Ann Thorac Surg. 2000 Sep;70(3):778-83.

Downloads

Published

03-04-2020

How to Cite

Utriyaprasit, K. ., Hengcharoensuwan, P. ., Sindhu, S. ., & Laksanabunsong, P. . (2020). Relationship between Selected Factors and Length of Hospital Stay in Coronary Artery Bypass Graft Patients. Siriraj Medical Journal, 63(2), 52–57. Retrieved from https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/240907

Issue

Vol. 63 No. 2 (2011): March-April

Section

Original Article

License

Users are free to share, copy, and redistribute all articles published in the Siriraj Medical Journal (SMJ) in any medium or format as long as you follow the following terms:

  • Attribution — You must give appropriate credit, provide a link to the material, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the publisher endorses you or your use.
  • NonCommercial — You may not use the material for commercial purposes.
  • NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.