CABG Annotated Bibliography and Bibliography

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    Annotated Bibliography

    Allen, L. A., Hernandez, A. F., Peterson, E. D., Curtis, L. H., Dai, D., Masoudi, F. A., Fonarow, G.C. (2011). Discharge to a skilled nursing facility and subsequent clinical outcomes among olderpatients hospitalized for heart failure. Circulation. Heart Failure, 4(3), 293300.

    doi:10.1161/CIRCHEARTFAILURE.110.959171

    Observational analysis: Patient factors associated with discharge to SNF included longer

    length of stay, advanced age, female sex, hypotension, higher ejection fraction, absence of

    ischemic heart disease, and a variety of comorbidities

    Andrikopoulos, G., Tzeis, S., Mantas, I., Olympios, C., Kitsiou, A., Kartalis, A., Vardas, P. (2012).Epidemiological characteristics and in-hospital management of acute coronary syndrome patientsin Greece: results from the TARGET study.Hellenic Journal of Cardiology: HJC = HellnikKardiologik Epithers, 53(1), 3340. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/22275741

    Conduction of national surveys:The TARGET study is a [two phase] observational study

    ClinicalTrials.gov link:http://clinicaltrials.gov/ct2/show/NCT01061086

    Bates, O. L., OConnor, N., Dunn, D., & Hasenau, S. M. (2014). Applying STAAR interventions inincremental bundles: improving post-CABG surgical patient care. Worldviews on Evidence-Based Nursing / Sigma Theta Tau International, Honor Society of Nursing, 11(2), 8997.doi:10.1111/wvn.12028

    Qualitative comparative study: Unlike the Hannan et al. (2011)study, the current study did

    not find a significant relationship between age, gender, race, or BMI and 30-day readmissions

    even though both samples were similar in makeup. Age was not found to be a statistically

    significant predictor of 30-day rehospitalization in other literature as well (Stewart et al.,2000).

    Several studies that looked at gender differences in CABG patients found female gender to have

    a statistically significant correlation with 30-day readmission

    http://www.ncbi.nlm.nih.gov/pubmed/21447803http://www.ncbi.nlm.nih.gov/pubmed/21447803http://www.ncbi.nlm.nih.gov/pubmed/21447803http://www.ncbi.nlm.nih.gov/pubmed/22275741http://www.ncbi.nlm.nih.gov/pubmed/22275741http://clinicaltrials.gov/ct2/show/NCT01061086http://clinicaltrials.gov/ct2/show/NCT01061086http://clinicaltrials.gov/ct2/show/NCT01061086http://dx.doi.org/10.1111%2Fwvn.12028http://dx.doi.org/10.1111%2Fwvn.12028http://dx.doi.org/10.1111%2Fwvn.12028http://onlinelibrary.wiley.com/doi/10.1111/wvn.12028/full#wvn12028-bib-0010http://onlinelibrary.wiley.com/doi/10.1111/wvn.12028/full#wvn12028-bib-0010http://onlinelibrary.wiley.com/doi/10.1111/wvn.12028/full#wvn12028-bib-0010http://onlinelibrary.wiley.com/doi/10.1111/wvn.12028/full#wvn12028-bib-0026http://onlinelibrary.wiley.com/doi/10.1111/wvn.12028/full#wvn12028-bib-0026http://onlinelibrary.wiley.com/doi/10.1111/wvn.12028/full#wvn12028-bib-0026http://onlinelibrary.wiley.com/doi/10.1111/wvn.12028/full#wvn12028-bib-0026http://onlinelibrary.wiley.com/doi/10.1111/wvn.12028/full#wvn12028-bib-0010http://dx.doi.org/10.1111%2Fwvn.12028http://clinicaltrials.gov/ct2/show/NCT01061086http://www.ncbi.nlm.nih.gov/pubmed/22275741http://www.ncbi.nlm.nih.gov/pubmed/21447803
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    Carey, J. S., Parker, J. P., Robertson, J. M., Misbach, G. A., & Fisher, A. L. (2003). Hospitaldischarge to other healthcare facilities: impact on in-hospital mortality.Journal of the AmericanCollege of Surgeons, 197(5), 806812. doi:10.1016/j.jamcollsurg.2003.07.010

    Retrospective study: Transfer to another healthcare facility rather than discharge home is a

    common practice after cardiac surgery. A substantial percentage of in-hospital deaths occurs

    after discharge from the primary institution.

    Crouch, D. S., McLafferty, R. B., Karch, L. A., Mattos, M. A., Ramsey, D. E., Henretta, J. P., Sumner, D. S. (2001). A prospective study of discharge disposition after vascular surgery.Journal of Vascular Surgery, 34(1), 6268. doi:10.1067/mva.2001.115597

    Prospective study: reveals that a large proportion of patients (39%) had a decline in

    disposition after vascular surgery. A hospital stay more than 6 days, emergency operation, open

    operative wound, systemic complications, and minor amputation were strong independent

    predictors of decline. Factors significantly associated with a decline in disposition at discharge

    by univariate analysis included diabetes mellitus (P

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    Asians, Hispanics, and Native Americans were less likely to use [post-acute care services] after

    hospitalization

    Dolansky, M. A., Zullo, M. D., Hassanein, S., Schaefer, J. T., Murray, P., & Boxer, R. (2012).Cardiac rehabilitation in skilled nursing facilities: a missed opportunity.Heart & Lung: TheJournal of Critical Care, 41(2), 115124. doi:10.1016/j.hrtlng.2011.08.006

    Retrospective review + Surveys:Overall, 19 participants (21%) had 1 or more cardiac

    disorders that placed them in the AACVPR high-exercise risk category, indicating a potential for

    cardiac decompensation during exercise. Two additional indicators for the severity of illness

    were length of hospital stay (57% hospitalized for more than 1 week, n = 46) and chronic dialysis

    (10%, n = 8). Eight (6.4%) patients demonstrated cognitive impairment. Upon admission, 10

    patients (8%) were unable to walk, and only 5 regained the ability to walk as of discharge.

    Patients who did not regain their ability to walk were discharged to a long-term nursing home.

    Physical function, as measured by FIM scores upon both admission and discharge, was well

    below the midpoint of 72, indicating impairment. Thirty-eight percent of patients were receiving

    an antidepressant, and 16% (n = 13) presented documentation of daily complaints of pain at

    moderate intensity. Thirty percent of the patients had both 3 or more hospital complications and

    SNF complications. Comorbidity was high, ie, patients exhibited a mean of 3 comorbid

    conditions. The social variables that were measured included marital status (30% were married)

    and living arrangements (30% lived alone). TABLE INCLUDED

    Dunckley, M., Ellard, D., Quinn, T., & Barlow, J. (2008). Coronary artery bypass grafting: patientsand health professionals views of recovery after hospital discharge.European Journal of

    Cardiovascular Nursing: Journal of the Working Group on Cardiovascular Nursing of the

    European Society of Cardiology, 7(1), 3642. doi:10.1016/j.ejcnurse.2007.06.001

    http://www.sciencedirect.com/science/article/pii/S0147956311004717http://www.sciencedirect.com/science/article/pii/S0147956311004717http://www.sciencedirect.com/science/article/pii/S0147956311004717http://www.sciencedirect.com/science/article/pii/S0147956311004717#tbl1http://www.sciencedirect.com/science/article/pii/S0147956311004717#tbl1http://www.ncbi.nlm.nih.gov/pubmed/17644041http://www.ncbi.nlm.nih.gov/pubmed/17644041http://www.ncbi.nlm.nih.gov/pubmed/17644041http://www.ncbi.nlm.nih.gov/pubmed/17644041http://www.sciencedirect.com/science/article/pii/S0147956311004717#tbl1http://www.sciencedirect.com/science/article/pii/S0147956311004717
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    The most significant predictors of dying or still being in a facility at 1 year include being on

    dialysis, right heart failure, and having chronic lung disease. Considering perioperative

    complications, requiring prolonged ventilation decreases the odds of being home and alive at 1

    year by 67%: one-year survival at home, 95.4%; rehabilitation, 63.6%; SNF, 52.3%; and LTAC,

    30.8%.

    Elfstrom, K. M., Hatefi, D., Kilgo, P. D., Puskas, J. D., Thourani, V. H., Guyton, R. A., & Halkos, M.E. (2012). What happens after discharge? An analysis of long-term survival in cardiac surgicalpatients requiring prolonged intensive care.Journal of Cardiac Surgery, 27(1), 1319.doi:10.1111/j.1540-8191.2011.01341.x

    Retrospective study: survival after discharge is significantly reduced in patients requiring

    prolonged ICU care.

    DISCUSSION OF RESULTS

    Filardo, G., Hamilton, C., Grayburn, P. A., Xu, H., Hebeler, R. F., Jr, & Hamman, B. (2012).Established preoperative risk factors do not predict long-term survival in isolated coronary arterybypass grafting patients. The Annals of Thoracic Surgery, 93(6), 19431948.doi:10.1016/j.athoracsur.2012.02.072

    A Cox survival model:Established operative risk factors may not be good predictors of

    long-term post-CABG survival. Late mortality may be attributable to many causes, not

    necessarily related to patients' cardiovascular and general health at the time of operation.

    TABLE OF PATIENT RISK FACTORS

    Fredericks, S. (2012). Memory loss following coronary artery bypass graft surgery: a discussion ofthe implications for nursing. Canadian Journal of Cardiovascular Nursing, 22(2), 3336.Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/22803287

    http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8191.2011.01341.x/abstracthttp://onlinelibrary.wiley.com/doi/10.1111/j.1540-8191.2011.01341.x/abstracthttp://onlinelibrary.wiley.com/doi/10.1111/j.1540-8191.2011.01341.x/abstracthttp://onlinelibrary.wiley.com/doi/10.1111/j.1540-8191.2011.01341.x/full#ss4http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8191.2011.01341.x/full#ss4http://www.sciencedirect.com/science/article/pii/S0003497512004341http://www.sciencedirect.com/science/article/pii/S0003497512004341http://www.sciencedirect.com/science/article/pii/S0003497512004341http://www.sciencedirect.com/science/article/pii/S0003497512004341#tbl1http://www.sciencedirect.com/science/article/pii/S0003497512004341#tbl1http://www.ncbi.nlm.nih.gov/pubmed/22803287http://www.ncbi.nlm.nih.gov/pubmed/22803287http://www.ncbi.nlm.nih.gov/pubmed/22803287http://www.ncbi.nlm.nih.gov/pubmed/22803287http://www.sciencedirect.com/science/article/pii/S0003497512004341#tbl1http://www.sciencedirect.com/science/article/pii/S0003497512004341http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8191.2011.01341.x/full#ss4http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8191.2011.01341.x/abstract
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    Discussion: Age combined with the effects of the surgical procedure increases the likelihood

    that individuals over the age of 65 years will experience some form of memory loss following

    surgery. Currently, nursing practice does not routinely incorporate assessment and

    management of memory loss into the overall plan of care for patients following heart surgery.

    Gehlbach, B. K., Salamanca, V. R., Levitt, J. E., Sachs, G. A., Sweeney, M. K., Pohlman, A. S., Hall, J. B. (2011). Patient-related factors associated with hospital discharge to a care facility aftercritical illness.American Journal of Critical Care: An Official Publication, AmericanAssociation of Critical-Care Nurses, 20(5), 378386. doi:10.4037/ajcc2011827

    Retrospective cohort study: Approximately one-quarter of the survivors of critical illness were

    discharged to a care facility instead of to home. This event occurred more commonly in older

    patients, even after adjustment for severity of illness and comorbid conditions. The risk was

    greatest for patients who received mechanical ventilation or had hospitalizations characterized by

    severe cognitive dysfunction or poor strength and/or mobility.

    Griffo, R., Fattirolli, F., Temporelli, P. L., & Tramarin, R. (2008). Italian survey on cardiacrehabilitation and secondary prevention after cardiac revascularization: ICAROS study. A surveyfrom the Italian cardiac rehabilitation network: rationale and design.Monaldi Archives for ChestDisease = Archivio Monaldi per Le Malattie Del Torace / Fondazione Clinica Del Lavoro,

    IRCCS [and] Istituto Di Clinica Tisiologica E Malattie Apparato Respiratorio, Universit Di

    Napoli, Secondo Ateneo, 70(3), 99104, 106. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/19040122

    Prospective, Longitudinal, Multicentric Survey w/ online data collection: NO FULL TEXT

    W/ RESULTS*

    Hall, M. H., Esposito, R. A., Pekmezaris, R., Lesser, M., Moravick, D., Jahn, L., Hartman, A. R.

    (2014). Cardiac surgery nurse practitioner home visits prevent coronary artery bypassgraft readmissions. The Annals of Thoracic Surgery, 97(5), 14881495.doi:10.1016/j.athoracsur.2013.12.049

    http://ajcc.aacnjournals.org/content/20/5/378http://ajcc.aacnjournals.org/content/20/5/378http://ajcc.aacnjournals.org/content/20/5/378http://www.ncbi.nlm.nih.gov/pubmed/19040122http://www.ncbi.nlm.nih.gov/pubmed/19040122http://www.sciencedirect.com/science/article/pii/S0003497514001118http://www.sciencedirect.com/science/article/pii/S0003497514001118http://www.sciencedirect.com/science/article/pii/S0003497514001118http://www.sciencedirect.com/science/article/pii/S0003497514001118http://www.ncbi.nlm.nih.gov/pubmed/19040122http://ajcc.aacnjournals.org/content/20/5/378
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    Analysis: Odds ratios for readmission of other covariates, controlling for other factors in the

    model, were: dialysis patients, 3.11-times more likely to be readmitted than nondialysis patients;

    Medicaid patients, 2.17; women, 1.87-times more likely to be readmitted than men; non-

    Caucasian patients, 1.86; chronic obstructive pulmonary disease patients, 1.78; diabetic patients,

    1.26; and patients with current congestive heart failure, 1.09.

    TABLE OF PROPENSITY SCORE MATCHING

    Hawkes, A. L., Nowak, M., Bidstrup, B., & Speare, R. (2006). Outcomes of coronary artery bypassgraft surgery. Vascular Health and Risk Management, 2(4), 477484. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/17323602

    Literature review: Risk factors for re-hospitalization include: length of stay in intensive care;

    severe non-cardiac complications; duration and severity of pre-operative cardiac symptoms;

    intra-aortic balloon insertion; pre-operative resting angina; female gender; age; diabetes; and

    surgical procedure (patients with left internal mammary artery graft or multiple arterial grafts are

    less likely to be re-hospitalized)

    Hyder, J. A., Wakeam, E., Habermann, E. B., Hess, E. P., Cima, R. R., & Nguyen, L. L. (2014).Derivation and validation of a simple calculator to predict home discharge after surgery.Journalof the American College of Surgeons, 218(2), 226236. doi:10.1016/j.jamcollsurg.2013.11.002

    We used the American College of Surgeons National Surgical Quality Improvement

    Program (ACS NSQIP) Patient User File for 2011: This study attempted to create a tool that

    patients could use to predict a patient-centered outcome.This study aimed to derive and

    validate a Home Calculator to predict home discharge for surgical patients. The resultant tool

    http://www.sciencedirect.com/science/article/pii/S0003497514001118#tbl2http://www.sciencedirect.com/science/article/pii/S0003497514001118#tbl2http://www.ncbi.nlm.nih.gov/pubmed/17323602http://www.ncbi.nlm.nih.gov/pubmed/17323602http://www.sciencedirect.com/science/article/pii/S1072751513011861http://www.sciencedirect.com/science/article/pii/S1072751513011861http://www.sciencedirect.com/science/article/pii/S1072751513011861http://www.sciencedirect.com/science/article/pii/S1072751513011861http://www.ncbi.nlm.nih.gov/pubmed/17323602http://www.sciencedirect.com/science/article/pii/S0003497514001118#tbl2
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    demonstrated excellent predictive ability across diverse surgical samples, and its simplicity may

    encourage use by patients themselves or with assistance from nurses before as part of a surgical

    consultation with anticipatory discharge planning.

    Jarzbek, R., Bugajski, P., Greberski, K., Baszczyski, J., Sowiska-Jarzbek, B., & Kalawski, R.(2014). Readmission to the intensive care unit after cardiac surgery: reasons and outcome.Kardiologia Polska. doi:10.5603/KP.a2014.0062

    Retrospective study: The main causes of readmission were cardiovascular instability (28.6%, n

    = 16), respiratory failure (23.2%, n = 13) and cardiac tamponade or bleeding (23.2%, n = 13).

    The mean length of stay (LOS) in the general cardiac ward after primary discharge from the ICU

    to readmission was 3.5 4.2 days. Length of ICU readmission was 12.5 21.2 days.

    Keeping-Burke, L., Purden, M., Frasure-Smith, N., Cossette, S., McCarthy, F., & Amsel, R. (2013).Bridging the transition from hospital to home: effects of the VITAL telehealth program onrecovery for CABG surgery patients and their caregivers.Research in Nursing & Health, 36(6),540553. doi:10.1002/nur.21571

    Randomized controlled trial: caregivers who received telehealth follow-up had greater

    improvements in anxiety levels from pre-surgery to 3 weeks after discharge than did those who

    received standard care

    Lazar, H. L., Fitzgerald, C. A., Ahmad, T., Bao, Y., Colton, T., Shapira, O. M., & Shemin, R. J.(2001). Early discharge after coronary artery bypass graft surgery: are patients really going homeearlier? The Journal of Thoracic and Cardiovascular Surgery, 121(5), 943950.doi:10.1067/mtc.2001.113751

    Analysis: Criteria for discharge from the hospital to home included a stable cardiac rhythm, an

    oral temperature of less than 37.5C (99F), a hematocrit value of 25% or more, oral intake of at

    http://ojs.kardiologiapolska.pl/kp/article/view/8044http://ojs.kardiologiapolska.pl/kp/article/view/8044http://ojs.kardiologiapolska.pl/kp/article/view/8044http://www.ncbi.nlm.nih.gov/pubmed/24242195http://www.ncbi.nlm.nih.gov/pubmed/24242195http://www.ncbi.nlm.nih.gov/pubmed/24242195http://www.sciencedirect.com/science/article/pii/S0022522301629465http://www.sciencedirect.com/science/article/pii/S0022522301629465http://www.sciencedirect.com/science/article/pii/S0022522301629465http://www.sciencedirect.com/science/article/pii/S0022522301629465http://www.ncbi.nlm.nih.gov/pubmed/24242195http://ojs.kardiologiapolska.pl/kp/article/view/8044
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    least 1000 calories per day, successful completion of an exercise test that included independent

    ambulation and the ability to climb one flight of stairs, no significant wound complications, and

    adequate home support systems. Patients not meeting these criteria were referred to extended

    care facilities. The individual surgeon was responsible for determining whether a patient should

    be sent home, have the hospital stay extended, or be referred to an extended care facility.

    Lopez, V., Ying, C., Poon, C., & Wai, Y. (2007). Physical, psychological and social recovery patternsafter coronary artery bypass graft surgery: a prospective repeated measures questionnaire survey.International Journal of Nursing Studies, 44(8), 13041315. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/16942769

    Prospective Study: This study looks at the physical, psychological and social recovery patterns.

    Martin, C. G., & Turkelson, S. L. (2006). Nursing care of the patient undergoing coronary arterybypass grafting. The Journal of Cardiovascular Nursing, 21(2), 109117. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/16601527

    Protocol Review: This article reviews the entire processfrom preoperative to postoperative

    and provides guidelines for dealing with complications that may arise after a CABG.

    McCarroll, K., Walsh, J. B., Coakley, D., Casey, M., Harbison, J., Robinson, D., Cunningham, C.(2013). Discharge of patients to long-term care from a large acute hospital over a 12-year period.Irish Journal of Medical Science, 182(3), 345348. doi:10.1007/s11845-012-0884-8

    Longitudinal study: (General, not CABG specific) 3,107 patients were listed and 2,520

    discharged to long-term care during the period. Mean age was 81.7 7.3 years and 64.1 % were

    female. The number listed increased since 1997, but there was no change in age or gender.

    Median time to discharge was 52 days, but varied by year and was longer for public versus

    http://www.ncbi.nlm.nih.gov/pubmed/16942769http://www.ncbi.nlm.nih.gov/pubmed/16942769http://www.ncbi.nlm.nih.gov/pubmed/16601527http://www.ncbi.nlm.nih.gov/pubmed/16601527http://link.springer.com/article/10.1007%2Fs11845-012-0884-8http://link.springer.com/article/10.1007%2Fs11845-012-0884-8http://link.springer.com/article/10.1007%2Fs11845-012-0884-8http://link.springer.com/article/10.1007%2Fs11845-012-0884-8http://www.ncbi.nlm.nih.gov/pubmed/16601527http://www.ncbi.nlm.nih.gov/pubmed/16942769
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    private facilities (mean difference = 18 days,P= 0.006). Mortality of those awaiting long-term

    care was 17.0 %, but varied significantly by year and ranged from 9.329.0 %. Mortality was

    higher in males, in those of older age and during the winter months.

    McKenzie, L. H., Simpson, J., & Stewart, M. (2010). A systematic review of pre-operative predictorsof post-operative depression and anxiety in individuals who have undergone coronary arterybypass graft surgery.Psychology, Health & Medicine, 15(1), 7493.doi:10.1080/13548500903483486

    Systematic Review: Collective appraisal of the studies indicated that symptoms of depression

    and anxiety exhibited after CABG surgery are best predicted by pre-operative measures of

    functioning in that area.These findings have clinical implications concerning the importance

    of pre and post-operative psychological assessment and intervention for individuals at risk of

    poor psychological recovery.

    Mullen-Fortino, M., & OBrien, N. (2008). Caring for a patient after coronary artery bypass graftsurgery.Nursing, 38(3), 4652; quiz 5253. doi:10.1097/01.NURSE.0000312627.12553.a1

    Review: Follow this system-by-system approach to keeping your patient stable and steering

    clear of complications.

    Nallamothu, B. K., Saint, S., Eagle, K. A., Langa, K. M., Fendrick, A. M., Hogikyan, R. V., Ramsey, S. D. (2002). Coronary artery bypass grafting in octogenarians: clinical and economicoutcomes at community-based healthcare facilities. The American Journal of Managed Care,8(8), 749755. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/12212762

    Retrospective cohort analysis: Of 338 patients 80 years or older, the in-hospital mortality rate

    was higher (4.7% vs 2.1%; P = .002), the rate of discharge to extended-care facilities was greater

    http://www.ncbi.nlm.nih.gov/pubmed/?term=20391226http://www.ncbi.nlm.nih.gov/pubmed/?term=20391226http://www.ncbi.nlm.nih.gov/pubmed/?term=20391226http://www.ncbi.nlm.nih.gov/pubmed/18418182http://www.ncbi.nlm.nih.gov/pubmed/18418182http://www.ncbi.nlm.nih.gov/pubmed/18418182http://www.ncbi.nlm.nih.gov/pubmed/12212762http://www.ncbi.nlm.nih.gov/pubmed/12212762http://www.ncbi.nlm.nih.gov/pubmed/12212762http://www.ncbi.nlm.nih.gov/pubmed/12212762http://www.ncbi.nlm.nih.gov/pubmed/18418182http://www.ncbi.nlm.nih.gov/pubmed/?term=20391226
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    (24.9% vs 4.8%; P < .001), the length of stay was longer (9.6 vs 7.9 days; P < .001), and in-

    hospital costs were higher ($20,188 vs $18,196; P < .001) compared with patients younger than

    80 years. After adjusting for several covariates, we found that octogenarians were at significantly

    greater risk of experiencing in-hospital deaths (odds ratio, 4.6; P = .001), of being discharged to

    extended-care facilities (odds ratio, 28.4; P < .001), and of having longer lengths of stay

    (difference, 0.7 days; P = .002) than were patients aged 50 to 59 years.

    Pattakos, G., Johnston, D. R., Houghtaling, P. L., Nowicki, E. R., & Blackstone, E. H. (2012).Preoperative prediction of non-home discharge: a strategy to reduce resource use after cardiac

    surgery.Journal of the American College of Surgeons, 214(2), 140147.doi:10.1016/j.jamcollsurg.2011.11.003

    Retrospective Cohort Study: Eighteen percent of patients had non-home discharge, which was

    predictable from data readily available at admission for cardiac surgery (C-statistic 0.88 for

    model development, 0.87 for model validation). The strongest predictors included intra-aortic

    balloon pumping (odds ratio [OR] 7.5; 95% confidence interval [CI] 1.7 to 32), emergency status

    (OR 3.7; CI 2.1 to 6.5), older age (p < 0.001), longer preoperative stays (p < 0.001), poor

    nutritional state (p < 0.001), a number of comorbidities, and descending thoracic aorta

    procedures (OR 4.3; 95% CI 2.5 to 7.4).

    Poole, L., Leigh, E., Kidd, T., Ronaldson, A., Jahangiri, M., & Steptoe, A. (2014). The combinedassociation of depression and socioeconomic status with length of post-operative hospital stayfollowing coronary artery bypass graft surgery: data from a prospective cohort study.Journal ofPsychosomatic Research, 76(1), 3440. doi:10.1016/j.jpsychores.2013.10.019

    Prospective Cohort Study: We showed that greater pre-operative depression symptoms on the

    BDI were associated with a longer hospital stay (hazard ratio = 0.978, 95% CI 0.957

    http://www.sciencedirect.com/science/article/pii/S1072751511012385http://www.sciencedirect.com/science/article/pii/S1072751511012385http://www.sciencedirect.com/science/article/pii/S1072751511012385http://www.sciencedirect.com/science/article/pii/S0022399913003978http://www.sciencedirect.com/science/article/pii/S0022399913003978http://www.sciencedirect.com/science/article/pii/S0022399913003978http://www.sciencedirect.com/science/article/pii/S0022399913003978http://www.sciencedirect.com/science/article/pii/S1072751511012385
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    0.999,p= .043) even after controlling for covariates, with the effect being observed for cognitive

    symptoms of depression but not somatic symptoms. Lower SES augmented the negative effect of

    depression on length of stay.[d]epression symptoms interact with socioeconomic position to

    affect recovery following cardiac surgery and further work is needed in order to understand the

    pathways of this association.

    Saab, S., Noureddine, S., & Dumit, N. Y. (2013). Readmission rates and emergency department visitsafter coronary artery bypass graft surgery and related factors.Le Journal Mdical Libanais. TheLebanese Medical Journal, 61(3), 155160. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/24422366

    Retrospective Review: Of the 110 patients studied, 9.1% were readmitted and 13.6% visited

    the ED within one month of discharge. The most frequent reasons for readmission were pleural

    effusion and dyspnea, and for ED visits, dyspnea and wound infection. Readmitted patients had

    fewer grafts performed than those who were not. Patients who visited the ED had higher

    incidence of bundle branch block and a trend towards higher body mass index than those who

    did not visit.

    Scrutinio, D., & Giannuzzi, P. (2008). Comorbidity in patients undergoing coronary artery bypassgraft surgery: impact on outcome and implications for cardiac rehabilitation.European Journalof Cardiovascular Prevention and Rehabilitation: Official Journal of the European Society of

    Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and

    Exercise Physiology, 15(4), 379385. doi:10.1097/HJR.0b013e3282fd5c6f

    Review: In a large contemporary database, 29.9% of the patients receiving isolated CABG had

    diabetes mellitus, 16% peripheral vascular disease, 18.6% chronic obstructive pulmonary

    disease, and 27.5% renal dysfunction. Patients with comorbidity are more likely to be old and

    often female, may have special care-requirements early after discharge, and are at increased risk

    http://www.ncbi.nlm.nih.gov/pubmed/24422366http://www.ncbi.nlm.nih.gov/pubmed/24422366http://cpr.sagepub.com/content/15/4/379http://cpr.sagepub.com/content/15/4/379http://cpr.sagepub.com/content/15/4/379http://cpr.sagepub.com/content/15/4/379http://www.ncbi.nlm.nih.gov/pubmed/24422366
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    for adverse outcomes. Contemporary available evidence indicates that older individuals, women,

    and patients with comorbidities are significantly less likely to receive cardiac rehabilitation.

    Shyu, Y.-I. L., & Lee, H.-C. (2002). Predictors of nursing home placement and home nursing servicesutilization by elderly patients after hospital discharge in Taiwan.Journal of Advanced Nursing,38(4), 398406. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/11985691

    Prospective study w/ case control design: (General discharge not CABG specific) The

    strongest predictors of institutionalization in a nursing home at 1, 3 and 6 months after discharge

    were the elderly person's pre-admission institutionalization (0.33 to 0.48) and the caregiver's

    preference for institutional displacement (0.23 to 0.85). The strongest predictors of use of home

    nursing services were the elder's self-care ability (0.69 to 0.76), conscious level (0.51 to 0.73),

    and tubes remaining before discharge (0.58 to 0.79). These predictors were stable at 1, 3 and 6

    months after discharge and could correctly classify 60-89% of sample.

    Siregar, S., de Heer, F., Groenwold, R. H. H., Versteegh, M. I. M., Bekkers, J. A., Brinkman, E. S., van Herwerden, L. A. (2014). Trends and outcomes of valve surgery: 16-year results of TheNetherlands Cardiac Surgery National Database.European Journal of Cardio-Thoracic Surgery:Official Journal of the European Association for Cardio-Thoracic Surgery.doi:10.1093/ejcts/ezu017

    Longitudinal Study: In 48.2% of valve surgery performed in 200709, the patient was directly

    discharged to home or another facility (such as a nursing home), and the remainder was

    discharged to another hospital

    Smith, E. R., & Stevens, A. B. (2009). Predictors of discharges to a nursing home in a hospital-basedcohort.Journal of the American Medical Directors Association, 10(9), 623629.doi:10.1016/j.jamda.2009.06.003

    http://www.ncbi.nlm.nih.gov/pubmed/11985691http://www.ncbi.nlm.nih.gov/pubmed/11985691http://www.ncbi.nlm.nih.gov/pubmed/11985691http://ejcts.oxfordjournals.org/content/early/2014/02/18/ejcts.ezu017http://ejcts.oxfordjournals.org/content/early/2014/02/18/ejcts.ezu017http://ejcts.oxfordjournals.org/content/early/2014/02/18/ejcts.ezu017http://www.sciencedirect.com/science/article/pii/S1525861009002394http://www.sciencedirect.com/science/article/pii/S1525861009002394http://www.sciencedirect.com/science/article/pii/S1525861009002394http://www.sciencedirect.com/science/article/pii/S1525861009002394http://ejcts.oxfordjournals.org/content/early/2014/02/18/ejcts.ezu017http://www.ncbi.nlm.nih.gov/pubmed/11985691
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    Retrospective hospital-based cohort design: Traditional risk factors, such as having less

    caregiving support, using more hospital services, being more severely ill, and not understanding

    their illness, characterized persons discharged to the NH compared with community-discharged

    persons. Significant predictors of being discharged to the NH included longer hospitalizations,

    not understanding one's illness, being female, living alone, not having a caregiver, needing

    assistance with dressing, and having a fall risk.

    Theobald, K., & McMurray, A. (2004). Coronary artery bypass graft surgery: discharge planning forsuccessful recovery.Journal of Advanced Nursing, 47(5), 483491. doi:10.1111/j.1365-

    2648.2004.03127.x

    Naturalistic Inquiry + Interviews + Thematic Analysis: This paper reports a study to

    examine the range of post-discharge issues, concerns and needs of patients and their family

    carers after discharge after CABG surgery, and explore their perceptions of unmet needs 1 year

    later.

    Vincent, H. K., & Vincent, K. R. (2008). Functional and economic outcomes of cardiopulmonarypatients: a preliminary comparison of the inpatient rehabilitation and skilled nursing facilityenvironments.American Journal of Physical Medicine & Rehabilitation / Association ofAcademic Physiatrists, 87(5), 371380. doi:10.1097/PHM.0b013e31816dd251

    Retrospective Exploratory Study: More patients achieved functional independence, had

    shorter LOS, and had a higher rate of homebound discharge in the IRF than in the SNF, and this

    is associated with a higher cost of care. These SNF outcomes may be related to advancing age,

    type of illness, dementia, and inability to fully participate in therapies.

    http://www.ncbi.nlm.nih.gov/pubmed/15312111http://www.ncbi.nlm.nih.gov/pubmed/15312111http://www.ncbi.nlm.nih.gov/pubmed/15312111http://www.ncbi.nlm.nih.gov/pubmed/15312111http://www.ncbi.nlm.nih.gov/pubmed/18427219http://www.ncbi.nlm.nih.gov/pubmed/18427219http://www.ncbi.nlm.nih.gov/pubmed/18427219http://www.ncbi.nlm.nih.gov/pubmed/18427219http://www.ncbi.nlm.nih.gov/pubmed/15312111http://www.ncbi.nlm.nih.gov/pubmed/15312111
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    Walters, D. M., Nagji, A. S., Stukenborg, G. J., Peluso, M. R., Taylor, M. D., Kozower, B. D., Jones, D. R. (2014). Predictors of hospital discharge to an extended care facility after majorgeneral thoracic surgery. The American Surgeon, 80(3), 284289. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/24666870

    Prospective Study: The following risk factors were selected a priori based on clinical

    judgment: age, preoperative albumin, preoperative Zubrod score, history of peripheral vascular

    disease, and use of home oxygen. Multiple logistic regression analysis was used to estimate the

    statistical significance and magnitude of risk associated with each predictor of patient discharge

    to extended care facilities. Of the 1646 patients identified, 68 (4.1%) were discharged to

    extended care facilities. Hospital length of stay was on average six days longer for patients

    discharged to these facilities than for patients discharged home (P < 0.0001). Multivariate

    analysis demonstrated that advanced age, lower preoperative albumin, and increased

    preoperative Zubrod score were statistically significant predictors of discharge to extended care

    facilities. Age, preoperative nutritional status, and functional status are strong predictors of

    patient discharge to extended care facilities. Early identification of these patients may improve

    patient discharge planning and reduce hospital length of stay after major thoracic surgery.

    Wong, A., Elderkamp-de Groot, R., Polder, J., & van Exel, J. (2010). Predictors of long-term careutilization by Dutch hospital patients aged 65+.BMC Health Services Research, 10, 110.doi:10.1186/1472-6963-10-110

    Retrospective Study: A higher age, longer stay in the hospital and absence of a spouse were

    found to be associated with a higher risk of all three types of long-term care. Individuals with a

    child had a lower risk of requiring residential care. Cerebrovascular diseases [relative risk ratio

    (RRR) = 11.5] were the strongest disease predictor of nursing home admission, and fractures of

    the ankle or lower leg (RRR = 6.1) were strong determinants of admission to a home for the

    http://www.ncbi.nlm.nih.gov/pubmed/24666870http://www.ncbi.nlm.nih.gov/pubmed/24666870http://www.biomedcentral.com/1472-6963/10/110http://www.biomedcentral.com/1472-6963/10/110http://www.biomedcentral.com/1472-6963/10/110http://www.biomedcentral.com/1472-6963/10/110http://www.ncbi.nlm.nih.gov/pubmed/24666870
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    elderly. Lung cancer (RRR = 4.9) was the strongest determinant of discharge to the home with

    home care.

    Zingone, B., Gatti, G., Rauber, E., Tiziani, P., Dreas, L., Pappalardo, A., Spina, A. (2009). Earlyand late outcomes of cardiac surgery in octogenarians. The Annals of Thoracic Surgery, 87(1),7178. doi:10.1016/j.athoracsur.2008.10.011

    Retrospective Review: Risk factors for hospital death were emergency status, preoperative

    renal dysfunction, and postoperative complications such as myocardial infarction, cardiac failure

    requiring intraaortic balloon pumping, acute renal failure requiring replacement therapy, stroke,

    and ventilator dependency exceeding 48 hours. Among hospital survivors, risk factors for late

    death were carotid artery disease, chronic lung disease, renal dysfunction, and the occurrence of

    postoperative complications.

    Search terms/keywords: Cardiac Surgical Procedures; Coronary Artery Bypass Graft (CABG);

    Coronary Artery Bypass/nursing; Coronary Artery Bypass /mortality; Hospital/mortality;

    Institutionalization; Interventions; Length of Stay; Logistic Models; Patient Admission/statistics

    & numerical data; Patient Discharge/statistics & numerical data; Postoperative; Probability;Skilled Nursing Facilities/utilization; Surgical outcomes; Thoracic surgery;

    *Full text can be requested if interested

    Christina MagnificoResearch and Learning SpecialistArchie R. Dykes Library, Research and LearningThe University of Kansas Medical CenterG023A [email protected]

    Dykes LibraryResearch and Learning DepartmentG023 Murphy Administration BuildingThe University of Kansas Medical [email protected]

    http://www.sciencedirect.com/science/article/pii/S0003497508022224http://www.sciencedirect.com/science/article/pii/S0003497508022224http://www.sciencedirect.com/science/article/pii/S0003497508022224mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]://www.sciencedirect.com/science/article/pii/S0003497508022224
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    Saab, S., Noureddine, S., & Dumit, N. Y. (2013). Readmission rates and emergency department visits

    after coronary artery bypass graft surgery and related factors.Le Journal Mdical Libanais. The

    Lebanese Medical Journal, 61(3), 155160.

    Scrutinio, D., & Giannuzzi, P. (2008). Comorbidity in patients undergoing coronary artery bypass

    graft surgery: impact on outcome and implications for cardiac rehabilitation.European Journal

    of Cardiovascular Prevention and Rehabilitation: Official Journal of the European Society of

    Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and

    Exercise Physiology, 15(4), 379385. doi:10.1097/HJR.0b013e3282fd5c6f

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    utilization by elderly patients after hospital discharge in Taiwan.Journal of Advanced Nursing,

    38(4), 398406.

    Siregar, S., de Heer, F., Groenwold, R. H. H., Versteegh, M. I. M., Bekkers, J. A., Brinkman, E. S.,

    van Herwerden, L. A. (2014). Trends and outcomes of valve surgery: 16-year results of The

    Netherlands Cardiac Surgery National Database.European Journal of Cardio-Thoracic Surgery:

    Official Journal of the European Association for Cardio-Thoracic Surgery.

    doi:10.1093/ejcts/ezu017

    Smith, E. R., & Stevens, A. B. (2009). Predictors of discharges to a nursing home in a hospital-based

    cohort.Journal of the American Medical Directors Association, 10(9), 623629.

    doi:10.1016/j.jamda.2009.06.003

    Theobald, K., & McMurray, A. (2004). Coronary artery bypass graft surgery: discharge planning for

    successful recovery.Journal of Advanced Nursing, 47(5), 483491. doi:10.1111/j.1365-

    2648.2004.03127.x

    Vincent, H. K., & Vincent, K. R. (2008). Functional and economic outcomes of cardiopulmonary

    patients: a preliminary comparison of the inpatient rehabilitation and skilled nursing facility

    environments.American Journal of Physical Medicine & Rehabilitation / Association of

    Academic Physiatrists, 87(5), 371380. doi:10.1097/PHM.0b013e31816dd251

    Walters, D. M., Nagji, A. S., Stukenborg, G. J., Peluso, M. R., Taylor, M. D., Kozower, B. D.,

    Jones, D. R. (2014). Predictors of hospital discharge to an extended care facility after major

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    Wong, A., Elderkamp-de Groot, R., Polder, J., & van Exel, J. (2010). Predictors of long-term care

    utilization by Dutch hospital patients aged 65+.BMC Health Services Research, 10, 110.

    doi:10.1186/1472-6963-10-110

    Zingone, B., Gatti, G., Rauber, E., Tiziani, P., Dreas, L., Pappalardo, A., Spina, A. (2009). Early

    and late outcomes of cardiac surgery in octogenarians. The Annals of Thoracic Surgery, 87(1),

    7178. doi:10.1016/j.athoracsur.2008.10.011

    Christina Magnifico

    Research and Learning SpecialistArchie R. Dykes Library, Research and LearningThe University of Kansas Medical CenterG023A Murphy913-588-7443

    [email protected]

    Dykes LibraryResearch and Learning DepartmentG023 Murphy Administration BuildingThe University of Kansas Medical Center913-945-5990

    d[email protected]

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]