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The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting
BACKGROUND: We aimed to investigate the associations of critical care provided in a cardiac surgical intensive care unit (CSICU) staffed by an attending intensivist with improvements in intensive care unit (ICU) quality and reductions in postoperative complications. METHODS: Patients who underwent e...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society for Thoracic and Cardiovascular Surgery
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006613/ https://www.ncbi.nlm.nih.gov/pubmed/32090052 http://dx.doi.org/10.5090/kjtcs.2020.53.1.8 |
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author | Kim, Dong Jung Sohn, Bongyeon Kim, Hakju Chang, Hyoung Woo Lee, Jae Hang Kim, Jun Sung Lim, Cheong Park, Kay-Hyun |
author_facet | Kim, Dong Jung Sohn, Bongyeon Kim, Hakju Chang, Hyoung Woo Lee, Jae Hang Kim, Jun Sung Lim, Cheong Park, Kay-Hyun |
author_sort | Kim, Dong Jung |
collection | PubMed |
description | BACKGROUND: We aimed to investigate the associations of critical care provided in a cardiac surgical intensive care unit (CSICU) staffed by an attending intensivist with improvements in intensive care unit (ICU) quality and reductions in postoperative complications. METHODS: Patients who underwent elective isolated coronary artery bypass grafting (CABG) between January 2007 and December 2012 (the control group) were propensity-matched (1:1) to CABG patients between January 2013 and June 2018 (the intensivist group). RESULTS: Using propensity score matching, 302 patients were extracted from each group. The proportion of patients with at least 1 postoperative complication was significantly lower in the intensivist group than in the control group (17.2% vs. 28.5%, p=0.001). In the intensivist group, the duration of mechanical ventilation (6.4±13.7 hours vs. 13.7±49.3 hours, p=0.013) and length of ICU stay (28.7±33.9 hours vs. 41.7±90.4 hours, p=0.018) were significantly shorter than in the control group. The proportions of patients with prolonged mechanical ventilation (2.3% vs. 7.6%, p=0.006), delirium (1.3% vs. 6.3%, p=0.003) and acute kidney injury (1.3% vs. 5.3%, p=0.012) were significantly lower in the intensivist group than in the control group. CONCLUSION: A transition from an open ICU model with trainee coverage to a closed ICU model with attending intensivist coverage can be expected to yield improvements in CSICU quality and reductions in postoperative complications. |
format | Online Article Text |
id | pubmed-7006613 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Korean Society for Thoracic and Cardiovascular Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-70066132020-02-21 The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting Kim, Dong Jung Sohn, Bongyeon Kim, Hakju Chang, Hyoung Woo Lee, Jae Hang Kim, Jun Sung Lim, Cheong Park, Kay-Hyun Korean J Thorac Cardiovasc Surg Clinical Research BACKGROUND: We aimed to investigate the associations of critical care provided in a cardiac surgical intensive care unit (CSICU) staffed by an attending intensivist with improvements in intensive care unit (ICU) quality and reductions in postoperative complications. METHODS: Patients who underwent elective isolated coronary artery bypass grafting (CABG) between January 2007 and December 2012 (the control group) were propensity-matched (1:1) to CABG patients between January 2013 and June 2018 (the intensivist group). RESULTS: Using propensity score matching, 302 patients were extracted from each group. The proportion of patients with at least 1 postoperative complication was significantly lower in the intensivist group than in the control group (17.2% vs. 28.5%, p=0.001). In the intensivist group, the duration of mechanical ventilation (6.4±13.7 hours vs. 13.7±49.3 hours, p=0.013) and length of ICU stay (28.7±33.9 hours vs. 41.7±90.4 hours, p=0.018) were significantly shorter than in the control group. The proportions of patients with prolonged mechanical ventilation (2.3% vs. 7.6%, p=0.006), delirium (1.3% vs. 6.3%, p=0.003) and acute kidney injury (1.3% vs. 5.3%, p=0.012) were significantly lower in the intensivist group than in the control group. CONCLUSION: A transition from an open ICU model with trainee coverage to a closed ICU model with attending intensivist coverage can be expected to yield improvements in CSICU quality and reductions in postoperative complications. The Korean Society for Thoracic and Cardiovascular Surgery 2020-02 2020-02-05 /pmc/articles/PMC7006613/ /pubmed/32090052 http://dx.doi.org/10.5090/kjtcs.2020.53.1.8 Text en Copyright © 2020 by The Korean Society for Thoracic and Cardiovascular Surgery. All rights Reserved. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Research Kim, Dong Jung Sohn, Bongyeon Kim, Hakju Chang, Hyoung Woo Lee, Jae Hang Kim, Jun Sung Lim, Cheong Park, Kay-Hyun The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting |
title | The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting |
title_full | The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting |
title_fullStr | The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting |
title_full_unstemmed | The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting |
title_short | The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting |
title_sort | impact of an attending intensivist on the clinical outcomes of patients admitted to the cardiac surgical intensive care unit after coronary artery bypass grafting |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006613/ https://www.ncbi.nlm.nih.gov/pubmed/32090052 http://dx.doi.org/10.5090/kjtcs.2020.53.1.8 |
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