scholarly journals Effect of Early Rehabilitation on Physical Function in Patients Undergoing Coronary Artery Bypass Grafting: A Nationwide Inpatient Database Study

2021 ◽  
Vol 10 (4) ◽  
pp. 618
Author(s):  
Hiroyuki Ohbe ◽  
Kensuke Nakamura ◽  
Kazuaki Uda ◽  
Hiroki Matsui ◽  
Hideo Yasunaga
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Usual Care ◽  
Physical Function ◽  
Usual Care Group ◽  
Artery Bypass ◽  
Early Rehabilitation ◽  
Care Group ◽  
Bypass Grafting ◽  
Inpatient Database

It is unclear when to begin rehabilitation after coronary artery bypass grafting (CABG) in the intensive care unit (ICU). Using the Japanese Diagnosis Procedure Combination inpatient database from 2010 to 2018, we identified adult patients who underwent a CABG and who were admitted to the ICU for ≥3 consecutive days from the date of their CABG. Patients who started any rehabilitation program prescribed by physicians or therapists within 3 days of CABG were defined as the early rehabilitation group, and the remaining patients were defined as the usual care group. We identified 30,568 eligible patients, with 13,150 (43%) patients in the early rehabilitation group. An inverse probability of treatment weighting analyses showed that the Barthel Index score at discharge in the early rehabilitation group was significantly higher than that in the usual care group (difference: 3.2; 95% confidence interval: 1.5–4.8). The early rehabilitation group had significantly lower in-hospital mortality, total hospitalization costs, length of ICU stay, and hospital stay vs. the usual care group. Our results suggested that early rehabilitation by physicians or therapists beginning within 3 days of CABG was safe, as suggested by the low mortality and improved physical function in patients who underwent CABG.

The Usefulness of Professional Foot and Wound Care on Post-Saphenectomy Surgical Site Complications in Patients Undergoing Coronary Artery Bypass Grafting

2020 ◽  
Author(s):  
Melike Elif Teker Açıkel ◽  
Evren Teyfik İşçi ◽  
Nihatcan Divarci
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Wound Care ◽  
Artery Bypass ◽  
Care Group ◽  
Bypass Grafting ◽  
Foot Care ◽  
Artery Bypass Grafting ◽  
Surgical Site Complications

ABSTRACT Background: Venous vessel removal during coronary artery bypass grafting may cause undesired problems such as pain and skin infection in the surgical site. Objective: To investigate the usefulness of professional foot and wound care on the healing of saphenectomy surgical site in patients undergoing coronary artery bypass grafting (CABG). Methods: The present prospective study was conducted among 574 patients (>18 years) undergoing CABG with great saphenous vein harvesting, between May 2017 and May 2018. The patients were randomly divided into two groups based on the foot care into professional foot care group (PFCG) and the standard foot care group (SFCG) with 287 patients each. Postoperative surgical site complications were assessed on the first, second, third, fourth day, 1 week and 1 month interval. Results: The Mean age of patients in PFCG and SFCG groups was 59.71 ±9.9 and 60.34 ±11.22, respectively. Rate of Postoperative complications decreased on the follow up examinations in PFCG group as compared to SFCG group. A significant difference in the incidence of complications was observed on the fourth day (p=0.004) and after 1 month (p=0.029) of surgery between 2 groups. No significant correlation was determined between the length of the removed saphenous vein, number of arteries anastomosed and the post-saphenectomy complication rate at the first, second, third, and fourth days, at the first week, and first month in both groups except in PFCG where significant association was noted on the third postoperative day. Conclusion: Postoperative limb care by professional foot specialist decreases the postoperative complications in the surgical site.

scholarly journals Preoperative VolumE Replacement therapy in DIabetic patients undergoing coronary artery bypass grafting surgery: results from an open parallel group randomized Controlled Trial (VeRDiCT)

2019 ◽  
Vol 30 (1) ◽  
pp. 54-63 ◽  
Author(s):  
Kunal Sarkar ◽  
Rosie A Harris ◽  
Sian Wells ◽  
Tracy Harris ◽  
Madeleine Clout ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Usual Care ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Diabetic Patients ◽  
Bypass Grafting ◽  
Randomized Controlled ◽  
Volume Replacement Therapy

Abstract OBJECTIVES To investigate the effect of preoperative volume replacement therapy (VRT) on renal function, health outcome and time to fitness for discharge in diabetic patients undergoing coronary artery bypass grafting (CABG). METHODS In 2 parallel randomized controlled trials, diabetic patients were allocated to preoperative VRT (1 ml/kg/h of Hartmann’s solution for 12 h) or usual care. Primary outcome was time to fitness for discharge. Secondary outcomes included acute kidney injury, postoperative complications, patient-reported quality of life (QoL), hospital resource use and markers of renal, cardiac and inflammatory injury. RESULTS In total, 169 patients were randomized (84 VRT, 85 usual care; mean age 64 years; 88% male). Time to fitness for discharge was similar between groups [median 6 days; interquartile range 5.0–9.0 in both groups; hazard ratio 0.95, 95% confidence interval (CI) 0.65–1.38; P = 0.78]. Postoperative acute kidney injury was not statistically different (VRT: 27.7% vs usual care: 18.8%, odds ratio 1.72, 95% CI 0.82–3.59; P = 0.15). Estimated glomerular filtration rate (mean difference −0.92, 95% CI −4.18 to 2.25; P = 0.56), microalbumin/creatinine ratio [geometric mean ratio (GMR) 1.16, 95% CI 0.94–1.42; P = 0.16], N-acetyl-beta-d-glucosaminidase (GMR 1.08, 95% CI 0.83–1.40; P = 0.57), C-reactive protein (GMR 1.00, 95% CI 0.88–1.13; P = 0.94), troponin T (Trop-T; GMR 1.18, 95% CI 0.78–1.79; P = 0.39) and other secondary health outcomes were similar between groups. QoL improved in both groups at 3 months with no difference observed. CONCLUSIONS The use of preoperative VRT is not superior to usual care in diabetic patients undergoing CABG. Clinical trial registration number ISRCTN02159606.

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