Does age limit the effectiveness of clinical pathways after coronary artery bypass graft surgery

摘要: Background-Clinical pathways have been shown to be effective in reducing the length of hospital stay after isolated CABG. Few studies, however, focused specifically on outcomes regard elderly population. Methods and Results-We reviewed our experience with 445 consecutive patients (299 <70 years old [mean age. 58.2±0.5 years] 146 ≥70 75.6±0.3 years]) who underwent CABG expectation progressing through same 5-day postoperative pathway. Preoperatively, had a smaller body surface area (1.87±0.02 versus 2.00±0.01; P<0.001) higher incidence female gender (45.9% 26.8%; P=0.001), cerebrovascular disease (13.7% 7.0%; P=0.022), congestive heart failure (22.6% 13.4%; P=0.013), 3-vessel coronary artery (76.7% 65.9%; P=0.024). Postoperatively, red blood cell transfusion (28.8% 9.0%; atrial fibrillation (37.6% 11.7%; overall rate complications (46.6% 23.4%; P=0.001). Mortality were 5.5% 7.9±0.4 days for 1.0% 6.4±0.4 those (P=0.004 P=0.008), respectively. Of old, 34% discharged ≤5 days, 64% ≤7 82% ≤10 64%, 85%, 93%, respectively, younger (P=0.001 all). Multivariate analysis preoperative variables identified age (P<0.001), hypertension (P=0.017), chronic obstructive pulmonary (P=0.002), intra-aortic balloon pumping (P=0.003) as significantly related stay. However, when found different by univariate are added model, is only marginally significant (P=0.079), strongest predictors increased stay, along pneumonia (P<0.001 Conclusions-These data suggest that extraordinary modifications clinical not needed success patients. The largely attributable fibrillation.