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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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.

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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

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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 Murphy913-588-7443cmagnifico@kumc.edu

Dykes LibraryResearch and Learning DepartmentG023 Murphy Administration BuildingThe University of Kansas Medical Center913-945-5990dykesresearch@kumc.edu

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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 older

patients hospitalized for heart failure. Circulation. Heart Failure, 4(3), 293300.

doi:10.1161/CIRCHEARTFAILURE.110.959171

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 patients

in Greece: results from the TARGET study.Hellenic Journal of Cardiology: HJC = Hellnik

Kardiologik Epithers, 53(1), 3340.

Bates, O. L., OConnor, N., Dunn, D., & Hasenau, S. M. (2014). Applying STAAR Interventions in

Incremental Bundles: Improving Post-CABG Surgical Patient Care. Worldviews on Evidence-

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doi:10.1111/wvn.12028

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Christina Magnifico

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

cmagnifico@kumc.edu

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

dykesresearch@kumc.edu