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Predictors of Prolonged Hospitalization After Cardiac Surgery: Insights from a Retrospective Study
Session:
Sessão de Posters 25 - Cirurgia cardíaca
Speaker:
Adriana Rei Pacheco
Congress:
CPC 2024
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
26.11 Cardiovascular Surgery - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Adriana Rei Pacheco; Simão Carvalho; Diana Carvalho; Margarida Cabral; Rita Veiga; Raquel Ferreira; Nuno Ferreira; Rita Faria
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-family:"Segoe UI",sans-serif"><span style="color:#212121">From a clinical standpoint, there is extensive documentation indicating that individuals with an extended stay in hospital after cardiac surgery exhibit elevated rates of both in-hospital and long-term morbidity and mortality. Some of the risk factors for prolonged hospitalization have already been established, although others remain unclear.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-family:"Segoe UI",sans-serif"><span style="color:#212121">We sought to characterize predictors of prolonged hospitalization among cardiac surgery patients in an effort to guide future improvement efforts, and especially to clarify the role of aortic calcification in this context.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-family:"Segoe UI",sans-serif"><span style="color:#212121">Retrospective study including patients submitted to cardiac surgery who underwent prior CT scan. Thoracic aortic calcification was quantified using a volume-rendering method. Demographic data and comorbidities were also assessed.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-family:"Segoe UI",sans-serif"><span style="color:#212121">148 patients were included (mean age 70,5±4,9; 60,8% men). The most frequent comorbidities were dyslipidemia (75%), hypertension (77%) and diabetes (DM) (39.9%). The mean value of the thoracic aortic calcification volume (TACV) was 2,079±2,390 cm3. The mean value of EuroSCORE II was 3,2±10,4. The average length of stay was 9.5±8.2 days and the median was 7 days.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-family:"Segoe UI",sans-serif"><span style="color:#212121">The sample was divided into 2 groups: patients with hospitalization <1 week and > 1 week (group A and B, respectively), according to the median number of days of hospitalization. When compared, there was a statistically significant difference in relation to the presence of chronic kidney disease (CKD) (GFR<60mL/min/1.73) (p=0.009), atrial fibrillation (AF) (p=0.002), anemia (p= 0.022) and coronary artery disease (CAD) (p=0.042), which were more frequent in group B. The average creatinine (Cr) on admission of patients in group A was 0.99mg/dL, and 1.33 in group B (p=0.024). Calcification of the descending aorta also correlated with length of stay >7 days (p=0.025). Patients with higher TACV had longer hospitalization than patients with lower TACV (13.6 vs 8.0 days, p=0.001). Patients with a history of DM had an average length of stay of 15.6 days, compared to patients without, who on average were hospitalized for 8.7 days (p<0.001).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-family:"Segoe UI",sans-serif"><span style="color:#212121">In summary, CKD, AF, anemia and CAD were more prevalent in patients with stays exceeding 7 days. Elevated Cr levels, descending aorta calcification, and higher TACV were linked to prolonged hospital stays. Importantly, patients with DM had significantly longer hospitalization periods. These findings contribute valuable insights to guide future efforts in optimizing post-cardiac surgery care.</span></span></span></span></p>
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