Atrial fibrillation (AF) is a significant healthcare issue and can be particularly bothersome in the post coronary artery bypass graft (CABG) period leading to increased patient morbidity and increased hospital costs. In an effort to address this issue and to standardize medication administration practices, a set of post CABG atrial fibrillation oral amiodarone orders were developed.
Patients received a total of 600 mg of amiodarone daily for a maximum of five days or until patient discharge with the first dose administered via NGT before leaving the operating room. The order became effective fiscal year 2000 (FY00).
At least 83% of eligible patients have received the amiodarone prophylaxis since its institution. The atrial fibrillation incidence prior to the protocol initiation in fiscal years 1998 and 1999 was 25.9% and 23.4% respectively. The table
DIFFERENCES BETWEEN CABG PATIENTS WITH AND WITHOUT ATRIAL FIBRILLATIONFY% of PT’s with atrial fibrillationAverage increased length of stay with AF(Days)Average increased cost of stay with AF ($)P value for both parameters compared to non-AF CABG patients20009.72.13223.< .00120017.53.25060.< .001200212.51.95149.< .001illustrates the statistically significant response in both the average length of stay and dollar cost of the hospitalization.CONCLUSIONS/CLINICAL IMPLICATIONS: These data demonstrate that a standardized oral amiodarone regimen administered in the postoperative period can statistically significantly reduce overall hospital costs and patients’ length of stay.
R.A. Luke, None.