Medicine
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Our aim was to record preoperative and postoperative results in patients undergoing coronary artery bypass grafting, to examine the factors affecting reoperation, and to determine whether there is a gender difference in pre- and post-activity activity using the Duke Activity Status Index. ...
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Introduction: Our aim was to record preoperative and postoperative results in patients undergoing coronary artery bypass grafting, to examine the factors affecting reoperation, and to determine whether there is a gender difference in pre- and post-activity activity using the Duke Activity Status Index. Material and Methods: 151 patients who underwent isolated coronary artery bypass grafting. The median time from baseline to return to work after Duke Success for women and men was 8.0 months. In addition to baseline scores at postoperative follow-up, the effects of 47 variables were analyzed with logistic ordinal models. The appropriate model for subsequent scores was determined by reverse selection, keeping the variables if they met the criteria for a P-value less than 0.05.Results: Average scores on the Duke Activity Status Index (women, 21.5; men, 32.2; P < .001) and pretest scores (42.7 for women; 58.2 for men; P < .001) were lower in women than in men. Postoperative scores were lower in elderly patients with obstructive pulmonary disease, myocardial infarction, stroke, diabetes, vascular disease, severe postoperative pain, and return to the operating room. After adjusting for these factors, recovery scores remained lower for women (difference from men, 2.1 [95% confidence interval, 1.7-2.6]; P < .001).Conclusion: A number of preoperative, surgical variables, and postoperative factors are associated with functional recovery after coronary revascularization. Additionally, after adjusting for these variables, female sexuality was later associated with lower performance.
Medicine
Marjan Dehdilan; Khosrow Hashemzadeh
Abstract
Introduction: In adults, readmission within 30 days of heart surgery is a major factor in hospital costs for heart surgery, but current data on risk factors for readmission are scarce. Therefore, we sought to identify performance-adjusted risk factors for coronary artery bypass graft (CABG) re-admissions.Material ...
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Introduction: In adults, readmission within 30 days of heart surgery is a major factor in hospital costs for heart surgery, but current data on risk factors for readmission are scarce. Therefore, we sought to identify performance-adjusted risk factors for coronary artery bypass graft (CABG) re-admissions.Material and Methods: The records of patients who underwent CABG at our institution between 2012-14 were analyzed for contrast with prospectively recorded case studies, including New York Cardiac Surgery Reporting System (CSRS) events, prescriptions, and testing costs.Results: Read rate 13% ; The CSRS estimated value is 8.7% (observed/predicted ratio = 1.5). The median time from CABG discharge to readmission was 6 days (interquartile range [IQ] 3 to 13 days). The median length of hospital stay was 4 days (IQ 2 to 7 days). The most common causes of readmission were heart disease (n = 40 [25% of readmissions]) and pneumonia (n = 36 [23%]), including pleural effusions. In addition to CSRS status, serum creatinine excretion alone was not associated with increased readings (p=0.5) OR] 5.7, %95 GA 1.7 ila 18.7).Conclusion: Readmission for coronary artery bypass surgery remains an ongoing medical challenge. Given that readmissions usually occur within the first week after discharge and are usually short-term, attention is paid to follow-up care and risk of readmission (compare, for example, abnormal serum creatinine or abnormal reactivity) and/or multiple causes of readmission. may reduce readmission after CABG (eg, pleural effusion).
Health
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Statins are powerful lipid-lowering drugs that have been shown to be effective in preventing heart disease and reducing the risk of death and heart attack. It is unclear whether hyperlipidemic patients undergoing coronary artery bypass grafting benefit from the lipid-lowering effects of ...
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Introduction: Statins are powerful lipid-lowering drugs that have been shown to be effective in preventing heart disease and reducing the risk of death and heart attack. It is unclear whether hyperlipidemic patients undergoing coronary artery bypass grafting benefit from the lipid-lowering effects of statins. We sought to determine whether prior statin therapy could affect the outcome of hyperlipidemic patients undergoing coronary artery bypass grafting. Material and Methods: In this cross-sectional descriptive study conducted between 2012 and 2015, hyperlipidemia to mortality post anesthesia in patients who are candidates for coronary artery graft surgery was investigated. Results: Risk-adjusted multivariate logistic regression analysis showed that statin-treated hyperlipidemic (odds ratio, 0.42; 95% confidence interval, 0.26-0.69; P = .0007) ratio was 0.42; confidence interval, 0.26-0.69; P = .0007) was independently associated with a reduction in major in-hospital cardiac events, but not in-hospital mortality. A similarity score based on the previous 14 risk factors was performed to further control for bias. After similar correlations, randomized controlled trials confirmed that statin-treated hyperlipidemia and non-statin-treated eulipidemia were associated with reductions in major cardiovascular hospitalizations (difference odds ratio, 0.41; 95% confidence, 0.24-=0.71 [P. .0013] and odds) rate is 0. Conclusion: Although there was no increase in MACE in these normolipidemic patients who did not receive prior statin therapy, results from other CABG studies 6,7,8,9,16 and 25 in patients with heart disease were background in all patients who received CABG. LDL-C levels may benefit from long-term statin therapy. Although some of these patients did not see immediate short-term benefit, this study did not examine the long-term outcomes and future cardiovascular events of MACE. This group of patients may also benefit from a reduction in long-term MACE with statin therapy despite low preoperative LDL-C levels.
Medicine
Marjan Dehdilan; Khosrow Hashemzadeh
Abstract
Introduction: Postoperative onset atrial fibrillation (POAF) is a common complication of coronary artery bypass surgery (CABG). However, the long-term risk of thromboembolism in patients who develop POAF after CABG surgery is unknown. Also, there is no information about stroke prevention in this setting. ...
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Introduction: Postoperative onset atrial fibrillation (POAF) is a common complication of coronary artery bypass surgery (CABG). However, the long-term risk of thromboembolism in patients who develop POAF after CABG surgery is unknown. Also, there is no information about stroke prevention in this setting. To investigate the long-term risk of stroke and thromboembolism in patients with new-onset POAF after initial CABG alone compared with patients with non-functional non-valvular atrial fibrillation (NVAF)Material and Methods: This study used data from the Clinical Cardiac Surgery Database and the Danish National Registry to identify patients undergoing a primary CABG procedure and de novo CABG between January 1, 2000 and June 30, 2015. The age, sex, CHA2DS2-VASc score and year of diagnosis of these patients were compared with dysfunctional NVAF between 1 and 4. Data analysis was performed between 2012-15. Proportion of patients starting oral anticoagulation within 30 days and thromboembolic rate.Results: 115 patients who developed POAF after CABG surgery and 115 patients who developed NVAF were compared. In the total population of 10,540 patients, the median (interquartile range) age was 69 years.2 (63.7-74.7) years; 8675 patients (82.3%) were male. 175 POAF patients (8.4% and 3549 patients with NVAF (42.9%). The risk of thromboembolism was lower in the POAF group than in the NVAF group (18.3 vs. 29.7 events per 1000 person-years; adjusted hazard ratio [HR], 0.55; 95% confidence interval, 0.32-0.95; P = .03) and NVAF (adjusted HR, 0.59; 95% CI, 0.68; P < .001) compared with patients not receiving anticoagulant therapy.Conclusion: Patients undergoing CABG surgery had a longer risk of thromboembolic new POAF than those undergoing NVAF. These data do not support the view that de novo POAF should be considered the same as primary NVAF in terms of long-term thromboembolic risk.
Medicine
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Cardiovascular care has become an important part of the continuity of care for cardiac patients. Its use is recommended in today's cardiac diagnostic procedures. Despite well-documented morbidity and mortality outcomes, cardiac services are underutilized. The basic principles of cardiac ...
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Introduction: Cardiovascular care has become an important part of the continuity of care for cardiac patients. Its use is recommended in today's cardiac diagnostic procedures. Despite well-documented morbidity and mortality outcomes, cardiac services are underutilized. The basic principles of cardiac therapy are explained in detail. Improvements in cardiac referrals, recording, and completion are possible using new performance measures. Material and Methods: Most guidelines recommend moderate-intensity exercise (60 to 75% of your maximum heart rate based on your target heart rate or ideal heart rate) for at least 30 minutes a day, at least 5 days a week, and preferably every day. Borg aerobic exercise, such as brisk walking, should be supplemented with daily water sports (such as walking after work, gardening, and housework). Results: Regular physical activity has been shown to have many cardiovascular benefits, including weight loss, lowering blood pressure, controlling diabetes and improving blood lipids. An analysis of 11 rehabilitation studies involving 115 patients found that regular physical activity was associated with a 28% reduction in all-cause mortality (6.2% vs. 9.0%) with a difference of 0.72, 95% CI 0.54–0.95)), there was a 24% reduction in myocardial infarction recurrence, but this was not significant (hazard ratio 0.76, 95% CI 0.57–1). Conclusion: Cardiovascular therapy has been shown to be safe and effective in improving quality of life and reducing morbidity and mortality in cardiac patients. Despite proven benefits, it is still not used in the treatment of heart disease. More patients will benefit from effective technology by improving referral and participation in cardiovascular care programs and personalized services involving the patient's condition.
Medicine
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Coronary artery bypass grafting (CABG) surgery is associated with a high frequency of allogeneic blood transfusions in CABG patients due to acquired hemostatic complications. However, allogeneic blood transfusion increases the risk of infection, morbidity and mortality, as well as prolonged ...
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Introduction: Coronary artery bypass grafting (CABG) surgery is associated with a high frequency of allogeneic blood transfusions in CABG patients due to acquired hemostatic complications. However, allogeneic blood transfusion increases the risk of infection, morbidity and mortality, as well as prolonged hospital stay and increased hospital costs. It is important to identify patients who need injections to reduce their risk and minimize the use of allogeneic blood. The aim of this study was to determine the factors affecting the decision of red blood cell transplantation in patients undergoing elective primary CABG.Material and Methods: This is a cross section search based on reverse data analysis. All patients who underwent elective primary CABG were included in this study. Variables analyzed included age, gender, body weight, pre-hemoglobin (Hb) levels, patient comorbidities, and other medical conditions. Data were analyzed using SPSS software version 20.Results: 83.4% patients underwent RBC transfusion. Based on multiple logistic regression analysis, age only (odds ratio [OR] = 1.040, 95% confidence interval [CI]: 1.003, 1.001), Hb level (OR = 0.500, 95% CI: 0.387, 0.644, P < 0.001), and extracorporeal circulation time (OR = 1. 013, 95% CI: 1.004, 1.023, P < 0.001) was an important indicator of RBC cycle.Conclusion: By classifying patients according to the risk of RBC transfusion, high-risk patients can be identified and should be included in blood transfusion programs to reduce the risk of allogeneic infections.
Medicine
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Our primary aim was to examine postoperative complications in cardiac surgery patients and their relationship to the use of cardiopulmonary resuscitation (CPB). A secondary aim was to evaluate the association of postoperative complications with outcome measures. Material and Methods: Single-institution ...
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Introduction: Our primary aim was to examine postoperative complications in cardiac surgery patients and their relationship to the use of cardiopulmonary resuscitation (CPB). A secondary aim was to evaluate the association of postoperative complications with outcome measures. Material and Methods: Single-institution observational study of consecutive cardiac surgery patients over 1 year. Five cardiac cases and 15 extracardiac cases were studied. CPB use, CPB parameters, demographics and Risk Adjusted Classification of Congenital Cardiac Surgery (RACHS-1) levels were evaluated as complication risk factors. Outcomes examined included duration of mechanical ventilation, length of stay in pediatric hospital, length of stay, and mortality. Results: Logistic regression analysis, after adjusting for age, sex, prior sternotomy, and RACHS-1 level, provided insufficient evidence for an association between CPB support and the incidence of cardiovascular or extracardiac problems. For patients receiving CPB, longer duration of CPB, higher RACHS-1 levels, and lower CPB temperature were associated with more cardiovascular events (P < .01). Longer CPB duration and higher RACHS-1 levels were associated with more cardiovascular complications (P = .006). Postoperative complications were associated with longer ventilator time, longer pediatric heart failure hospital stay, longer hospital stay, and death (P < .01). Conclusion: Postoperative complications occurred in 43% of pediatric cardiac procedures with and without CPB. Complications include longer use of ventilators, pediatric heart failure and hospital stay, and increased mortality.
Medicine
Marjan Dehdilan; Khosrow Hashemzadeh
Abstract
Introduction: To evaluate the outcomes of phase I cardiac treatment of stress in hospitalized patients undergoing coronary artery bypass grafting (CABG).Material and Methods: 19 patients were assigned to (1) the phase I cardiac therapy (experimental) group and (2) the no intervention group (comparison). ...
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Introduction: To evaluate the outcomes of phase I cardiac treatment of stress in hospitalized patients undergoing coronary artery bypass grafting (CABG).Material and Methods: 19 patients were assigned to (1) the phase I cardiac therapy (experimental) group and (2) the no intervention group (comparison). Finally, 60 subjects were included in the data analysis.Psychological status was measured by anxiety scores on the State-Trait Anxiety Inventory. Anxiety scores were measured over 3 sessions: (1) after admission and before CABG surgery; (2) the day before CABG surgery; (3) release date. Interventions: Self-direction of exercise and daily activities as the first stage of cardiovascular therapy (Chinese handbook) during hospitalization. Data analysis was performed using estimation equations (GEE) to evaluate the inter- and intra-group differences.Results: The average stress level of all subjects before CABG surgery was 42.6. The mean stress level of the day before CABG surgery was 33.7 in the experimental group and 49.8 in the control group; there is a difference between the two groups with a significance level of P < .05. The mean stress of the experimental group on the day of discharge was 28.6, the control group was 38.4; there is a difference between the two groups with a significance level of P < .05.Conclusion: These results are supported by similar studies. This finding suggests that phase I cardiac therapy may reduce anxiety during hospitalization in patients who have undergone CABG surgery.
