Impact of Prophylactic Amiodarone on Length of Hospital Stay, Stroke, and Atrial Fibrillation After Cardiothoracic Surgery

Abstract Objective The purpose of this study was to explore differences in sedentary behavior, length of hospital stay, and discharge destination of patients before and after the Ban Bedcentricity implementation at ward-level. Methods The Ban Bedcentricity innovation and implementation procedure were implemented at the cardiothoracic surgery, cardiology, and orthopedics-traumatology wards. Sedentary behavior data were collected 2 weeks before and after the implementation using behavioral observations and analyzed with Pearson’s chi-square. Length of hospital stay and discharge destination data were collected from all admitted patients and analyzed with multiple and logistic regression analyses. Results Behavioral observations showed that in 52% of the observations patients were lying in bed before implementation and 40% after implementation at the cardiothoracic surgery, 64% and 46% at the cardiology, and 53% and 57% at the orthopedics-traumatology wards. The mean length of hospital stay after implementation (compared to before implementation) was 5.1 days at the cardiothoracic surgery (n = 1923; mean + +0.13 days; 95%CI = −0.32 to +0.60), 2.6 days at the cardiology (n = 2646; mean = −0.22 days; 95%CI = −0.29 to −0.14), and 2.4 days at the Orthopedics-Traumatology wards (n = 1598; mean = +0.28 days = 95%CI = +0.06 to +0.50). After the implementation, more patients were discharged home from the cardiothoracic surgery (odds ratio [OR = 1.23]; 95%CI = 1.07 to 1.37) and cardiology wards (OR = 1.37; 95%CI = 1.22 to 1.49), and no statistically significant difference was found at the orthopedics-traumatology ward (OR = 1.09; 95%CI = 0.88 to 1.27). Conclusions The outcomes indicate beneficial outcomes after the implementation with less sedentary behavior and proportionately more patients being discharged home, compared to before the implementation. However, little information is available about the adoption and fidelity of Ban Bedcentricity, therefore, outcomes should be interpreted with caution. Impact This multifaceted innovation to reduce sedentary behavior of patients during the hospital stay seems to be promising, with outcomes indicating less sedentary behavior in patients and more patients being discharged home after the implementation.

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P3632Comparison of intravenous vernakalant and electrical cardioversion in recent-onset atrial fibrillation: Effect on time to restore sinus rhythm and length of hospital stay

European Heart Journal ◽

10.1093/eurheartj/ehx504.p3632 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Cited By ~ 1

Author(s):

A.E. Heikkola ◽

H. Pohjantahti ◽

E. Sinisalo ◽

M. Aho ◽

H. Hyppola ◽

...

Keyword(s):

Atrial Fibrillation ◽

Sinus Rhythm ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Electrical Cardioversion ◽

Recent Onset ◽

Onset Atrial Fibrillation

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Metoprolol prophylaxis against postoperative atrial fibrillation increases length of hospital stay in patients not on pre-operative blockers: the blocker length of stay (BLOS) trial

Heart ◽

10.1136/hrt.2003.016048 ◽

2004 ◽

Vol 90 (8) ◽

pp. 941-942 ◽

Cited By ~ 21

Author(s):

E Crystal

Keyword(s):

Atrial Fibrillation ◽

Length Of Stay ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Postoperative Atrial Fibrillation

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Safe and effective protocol for discharge 3 days after cardiac surgery

Scientific Reports ◽

10.1038/s41598-021-88582-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Omar Asdrúbal Vilca Mejia ◽

Gabrielle Barbosa Borgomoni ◽

Nilza Lasta ◽

Mariana Yumi Okada ◽

Mariana Silva Biason Gomes ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiac Surgery ◽

Hospital Stay ◽

Latin American ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Length Of Hospital Stay ◽

Postoperative Stay ◽

Eras Protocol ◽

The Impact

AbstractThe Enhanced Recovery After Surgery (ERAS) protocol affected traditional cardiac surgery processes and COVID-19 is expected to accelerate its scalability. The aim of this study was to assess the impact of an ERAS-based protocol on the length of hospital stay after cardiac surgery. From January 2019 to June 2020, 664 patients underwent consecutive cardiac surgery at a Latin American center. Here, 46 patients were prepared for a rapid recovery through a multidisciplinary institutional protocol based on the ERAS concept, the “TotalCor protocol”. After the propensity score matching, 46 patients from the entire population were adjusted for 12 variables. Patients operated on the TotalCor protocol had reduced intensive care unit time (P < 0.025), postoperative stay (P ≤ 0.001) and length of hospital stay (P ≤ 0.001). In addition, there were no significant differences in the occurrence of complications and death between the two groups. Of the 10-central metrics of TotalCor protocol, 6 had > 70% adherences. In conclusion, the TotalCor protocol was safe and effective for a 3-day discharge after cardiac surgery. Postoperative atrial fibrillation and renal failure were predictors of postoperative stay > 5 days.

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Abstract TP231: Clinical Characteristics of TIA with Atrial Fibrillation

Stroke ◽

10.1161/str.44.suppl_1.atp231 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Yuka Kuronuma ◽

Toshiyuki Uehara ◽

Kazumi Kimura ◽

Yasushi Okada ◽

Yasuhiro Hasegawa ◽

...

Keyword(s):

Atrial Fibrillation ◽

Hospital Stay ◽

Clinical Symptoms ◽

Length Of Hospital Stay ◽

Using Data ◽

Ischemic Attack ◽

Definition Of ◽

And Diffusion ◽

Single Lesion ◽

Early Stroke

Objectives: Patients with transient ischemic attack (TIA) are at high risk of early stroke, indicating a need for urgent diagnostic workup and treatment. Atrial fibrillation (AF) is one of important causes for TIA. The purpose of this study was to investigate characteristics of TIA patients with AF, using data of a multicenter retrospective study. Methods: The subjects of this study were TIA patients admitted to 13 stroke centers within 7 days after onset between 2008 and 2009. The definition of TIA used in this study was that of clinical symptoms lasting less than 24 hours, regardless of imaging findings. We compared baseline characteristics and diffusion weighted-MRI (DWI) findings between patients with AF and those without AF. Results: A total of 464 patients (69 ± 13 years in age, 172 women) were enrolled. We diagnosed 79 patients (17%) as having AF. TIA patients with AF were older (74 ± 9 vs. 67 ± 14 years old, P = 0.0001) and more likely to have a longer length of hospital stay (15 ± 9 vs. 14 ± 20 days, P = 0.046) than those without AF. Of 464 TIA patients, 458 patients (99%) underwent head MRI. DWI lesion was detected in 96 (21%) patients. There was no difference of DWI positivity rate between patients with or without AF (28% vs. 20%, P = 0.10). Compared to patients without AF, patients with AF were more likely to have a single lesion on DWI (86% vs. 51%, P = 0.005). DWI lesion of ≥15 mm was found more frequently in TIA patients with AF than in those without AF (45% vs. 22%, P = 0.04). Conclusions: This study demonstrated that TIA patients with AF were older and had a longer length of hospital stay than those without AF. In addition, characteristics of DWI findings differed between TIA patient with AF and those without AF; TIA patients with AF were more likely to have a single lesion with a size of ≥15 mm.

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A clinical pathway for safely and effectively cardioverting emergency department patients with atrial fibrillation greater than 48 hours

10.22541/au.161400211.11696079/v1 ◽

2021 ◽

Author(s):

Baha Zaro ◽

Evan Avraham Alpert ◽

Nechama Kaufman ◽

David Rosenmann

Keyword(s):

Atrial Fibrillation ◽

Emergency Department ◽

Hospital Stay ◽

Clinical Pathway ◽

Group Versus ◽

Length Of Hospital Stay ◽

Electrical Cardioversion ◽

Transesophageal Echocardiogram ◽

Cardiology Department ◽

Emergency Department Patients

Background: The current emergency medicine literature on cardioversion for atrial fibrillation (AF), describes its performance on those who are hemodynamically unstable, present within 48 hours of the onset of the arrhythmia, or are on long term anticoagulants. This article describes a clinical pathway comparing patients presenting to the emergency department (ED) with atrial fibrillation (AF) of more than 48 hours who underwent a transesophageal echocardiogram (TEE) and subsequent cardioversion in the ED. The objective of this study is to evaluate such a pathway looking at the time to cardioversion, length of hospital stay, rate of successful cardioversion, and the rate of complications compared to the traditional pathway of admitting patients directly to the cardiology department for evaluation and treatment. Methods: This was a retrospective observational study of patients who presented to the ED with AF for more than 48 hours, underwent a transesophageal echocardiogram, and then were electrically cardioverted either in the emergency department versus the cardiology ward. Results: Electrical cardioversion was performed in the ED on 92 patients (61%) and the cardiology department on 59 (39%). Over 90% of cardioversions were successful in both groups. Time to cardioversion was significantly less in the ED group versus the cardiology group (1.03 ± 0.8 days versus 4.17 ± 1.9; p<0.001). Similarly, the mean length of hospital stay was less for the ED group (1.5± 1.5 days versus 7.2 ± 3.5; p<0.001). Conclusion: Patients who present in atrial fibrillation for more than 48 hours and then have a TEE, undergo electrical cardioversion faster in the ED compared to the cardiology ward. This clinical pathway also results in a shorter length of hospital stay without having more side effects.

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Determinants of Prolonged Length of Hospital Stay of Patients with Atrial Fibrillation

Journal of Clinical Medicine ◽

10.3390/jcm10163715 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3715

Author(s):

Ancuța Elena Vîjan ◽

Ioana Cristina Daha ◽

Caterina Delcea ◽

Gheorghe-Andrei Dan

Keyword(s):

Atrial Fibrillation ◽

Hospital Stay ◽

Multivariable Analysis ◽

Length Of Hospital Stay ◽

Limited Data ◽

Reduced Ejection Fraction ◽

Prolonged Length ◽

Hospitalization Rates ◽

Coronary Syndromes ◽

The Mean

Background and Aim: The increasing prevalence and high hospitalization rates make atrial fibrillation (AF) a significant healthcare strain. However, there are limited data regarding the length of hospital stay (LOS) of AF patients. Our purpose was to determine the main drivers of extended LOS of AF patients. Methods: All AF patients, hospitalized consecutively in a tertiary cardiology center, from January 2018 to February 2020 were included in this retrospective cohort study. Readmissions were excluded. Prolonged LOS was defined as more than seven days (the upper limit of the third quartile). Results: Our study included 949 AF patients, 52.9% females. The mean age was 72.5 ± 10.3 years. The median LOS was 4 days. A total of 28.7% had an extended LOS. Further, 82.9% patients had heart failure (HF). In multivariable analysis, the independent predictors of extended LOS were: acute coronary syndromes (ACS) (HR 4.60, 95% CI 1.66–12.69), infections (HR 2.61, 95% CI 1.44–3.23), NT-proBNP > 1986 ng/mL (HR 1.96, 95% CI 1.37–2.82), acute decompensated HF (ADHF) (HR 1.76, 95% CI 1.23–2.51), HF with reduced ejection fraction (HFrEF) (HR 1.69, 95% CI 1.15–2.47) and the HAS-BLED score (HR 1.42, 95% CI 1.14–1.78). Conclusion: ACS, ADHF, HFrEF, increased NT-proBNP levels, infections and elevated HAS-BLED were independent predictors of extended LOS, while specific clinical or therapeutical AF characteristics were not.

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