PURPOSE: The purpose of this study is to descriptively report the outcomes of cardiothoracic surgical patients (CTS) patients who were transferred to an Atlanta LTAC facility.
METHODS: All patients were identified between January 2004 to October 2009 had undergone CABG and or CVR surgery were transferred to LTAC. Abstracted medical records and clinical and laboratory data were analyzed.
RESULTS: Of the 5823 patients who underwent CTS procedures, 466 (8%) remained on mechanical ventilation for > 96 hrs. Among the 94 patients who went to LTAC, 45 were transferred the specific LTAC we studied. All have undergone tracheostomy and were on mechanical ventilation at the time of transfer. Among the 45 patients 37 were on full ventilatory support. Of those, 28 (76.7%) were successfully weaned. The average time to complete weaning was 20 ± 15 days. Among the 45 patients 29 underwent tracheostomy decannulation with an average of 29 days ± 18 days to decannulation. The average LOS was 38 ± 23 days. Among the 45 patients studied, 13 (28.9%) were transferred back to the ICU and 1 (2%) died in the LTAC. The incidence of new nosocomial infections (NIs) episodes was 51 with the most common being UTI (24/51). Despite the universal VTE prophylaxis, 8 (17.7%) patients developed VTE. Elective surgical patients (22) and emergent surgical patients (23) had has similar outcomes in terms of successful weaning and time to wean.
CONCLUSION: Our study shows that most CTS patients survived to leave the LTAC. Discontinuation of mechanical ventilation occurred in a majority of patients within a month. Approximately 30% of these patients may require ICU readmission. There was no difference between the emergent and elective surgical patients in terms of weaning success.
CLINICAL IMPLICATIONS: It is important to identify potentially modifiable risk factors that may impact on weaning outcomes in CTS patients.
DISCLOSURE: Zeena Nawas, No Financial Disclosure Information; No Product/Research Disclosure Information