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Heart surgery waiting list management in an ultra-peripheral region – experience of a center in Portugal
Session:
Prémio Machado Macedo/ CO 15- Cardiac Surgery
Speaker:
Fabiana Duarte
Congress:
CPC 2021
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
26.11 Cardiovascular Surgery - Other
Session Type:
Prémios
FP Number:
---
Authors:
Fabiana Silva Duarte ; Raquel Dourado; Maria Inês Barradas; Luís Oliveira; Cátia Serena; António Fontes; André Monteiro; Carla Almeida; Carina Machado; Emília Santos; Nuno Pelicano; Miguel Pacheco; Anabela Tavares; Dinis Martins
Abstract
<p><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><strong>Introduction: </strong>Heart surgery is becoming increasingly necessary and the geographic distance from large surgery centers may raise difficulties and limitations to patient referral.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><strong>Objectives: </strong>To characterize a cohort of patients with indication for heart surgery. To assess referral motives and waiting times for these patients, regarding surgery priority, in an ultra-peripheral region in Portugal.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><strong>Methods: </strong>Retrospective analysis of 420 patients waiting for heart surgery between January 2016 and September 2020. Criteria for surgery priority selection were based on the official recommendations from Sociedade Portuguesa de Cirurgia Cardio-Torácica e Vascular and Sociedade Portuguesa de Cardiologia.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><strong>Results: </strong>Out of 420 patients waiting for heart surgery, mean age was 64.8 ± 10.7 years and 74.3% were male. According to body mass index assessment 37.3% of patients were overweight and 39.1% were obese (degrees 1,2 or 3) and this was a determinant parameter for acceptance by some surgery centers. Most patients (48.3%) were referred and accepted in a surgery center of Portugal’s Southern region and about a third (33.8%) in the Center region. Regarding clinical condition, 49.0% of patients had coronary heart disease requiring Coronary Artery Bypass Grafting (CABG), 44.7% had aortic and/or mitral valvular disease, 1.0% acute aortic syndrome or ascending aorta aneurism, 1.9% infective endocarditis and the remaining 3.4% had other indications for heart surgery. High priority patients (10.2%) that awaited hospital transference had a mean waiting time of 14.81 ± 9.86 days, most (79.0%) requiring CABG. Patients considered prioritary or elective presented a mean waiting time of 195.7 ± 127.1 days and the three main motives for referral were CABG (41.0%), followed by aortic valve surgery (35.7%) and mitral valve surgery (7.38%).</span></span><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"> Waiting list mortality was 2.1%.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><strong>Conclusion: </strong>Due to geographic location particularities, the absence of Heart Surgery in the Region and the inexistence of an established protocol of referral for these patients, heart surgery waiting list management becomes of major importance. </span></span></p>
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