The profile and selected outcomes of coronary artery bypass graft (CABG) patients in the Cape Metropolitan Area : a baseline study
Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2007.
Study Aim: To describe the profile and selected outcomes of CABG patients admitted in the Cape metropolitan area. Design: A prospective descriptive study design with a multicentre observational approach was followed. Method: All patients undergoing isolated CABG surgery, whether elective or emergency, during a three-month period (15 August–15 November 2005) were included in the study. Demographic data, pre-operative medical status, intra-operative, as well as post-operative information were collected using a self-designed structured initial assessment form (SIA). Means and standard deviations were calculated where applicable. Relationships between different variables were analyzed by means of: ANOVA, correlations, linear and logistic regressions. Where it appeared that the ANOVA assumptions were violated, non-parametric bootstrap techniques were employed. Results: Two hundred and forty five patients were admitted to the seven hospitals which provide CABG surgery in the Cape metropolitan area in the allotted period. The profile of patients admitted to private and state institutions were similar. The mean age of the sample was 60 (±10). The mean LOS of the total cohort was 12 (±5.5) days, with patients in the state hospitals staying longer 13.4 days (± 7.1). Patients who were older than 60 were twice as likely to have a LOS >12days (odds ratio = 2.49; 95% confidence interval = 1.33 to 4.65). The development of a pleural effusion or pneumothorax was associated with an increased LOS (p<0.01). At least one PPC was reported in 65% of the population. A mortality rate of only 3% was reported. Conclusion: Patients in this cohort were younger than in developed countries. An age greater than 60 years was a predictor of an LOS >12days in the current cohort. Patients were most likely to develop a PPC on day three after CABG surgery. Physiotherapeutic intervention, if any, would be well aimed at those patients older than 60 years of age. Screening of patients in the first three post-operative days for the development of PPCs is also advised.