PMID: 8595570Jan 1, 1996Paper

Shared care for open heart surgery: 21 years' experience

The Canadian Journal of Cardiology
G M FitzGibbon, W J Keon

Abstract

To determine whether patients undergoing open heart surgery, the majority coronary artery bypass grafting (CABG), can safely be returned early to the smaller nonspecialized hospital that referred them for postoperative care by a cardiological team. Another objective is to determine what benefits might accrue from this practice and to whose credit. All 1696 patients, 1512 having coronary bypass alone or with ventricular aneurysm repair in 6%, referred from a military hospital with investigative facilities from November 1971 to November 1992 were studied with attention to length of postoperative stay in both hospitals, perioperative mortality and major complications mandating return to the surgical centre (which was almost always for reoperation). Time between initial coronary angiography and CABG was examined to see whether it related to the early return policy. After the first two years, postoperative care at the surgical hospital following CABG was reduced from a mean of 10.4 to 2.4 days, with an 18% reduction in the combined time spent at both hospitals, an estimated reduction of some 48 patient-years at the surgical hospital. A perceived need for active in-patient-rehabilitation and formal postoperative assessment explains t...Continue Reading

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