The effect of early follow-up after open cardiac surgery in a student clinic

Figures & data

Figure 1. Flow diagram for patient inclusion.

Table 1. Patient demographics and clinical characteristics of the total population.

	Intervention (n = 100)	Control (n = 319)
Characteristic
Sex (female, n (%))	21 (21)	57 (18)
Age (years, mean (SD))	66 (±9)	65 (±10)
Preoperative information
Reduced pulmonary function^a (n (%))	24 (24)	57 (18)
EuroScore II (logistic) (median (IQR))	2.7 (1.7;4.7)	2.4 (1.5;4.3)
Prior percutaneous coronary intervention (n (%))	10 (10)	49 (15)
Prior cardiac surgery (n (%))	3 (3)	14 (4)
Atrial fibrillation (n (%))	15 (15)	38 (12)
Diabetes^b (n (%))	25 (25)	43 (13)
Ejection fraction ≤50 (n (%))	33 (33)	99 (31)
Body Mass Index (mean (SD))	29 (±5)	28 (±5)
Current or former smoker (n (%))	13 (13)	38 (12)
Alcohol intake above national recommendation (n (%))	12 (12)	27 (8)
Operation
Type of operation, n (%)
Coronary artery bypass	58 (58)	180 (57)
Valve replacement(s)	23 (23)	83 (26)
Combined procedure	8 (8)	20 (6)
Other	11 (11)	36 (11)
Duration of ECC (min) (median (IQR))	95 (83;131)	98 (77;122)
Post-operative information before discharge
Re-operation (n (%))	3 (3)	13 (4)
Pleurocentesis (n (%))	20 (20)	59 (19)
Pericardiocenteis (n (%))	1 (1)	1 (0.3)
New onset postoperative atrial fibrillation (n (%))	36 (36)	127 (40)
Length-of-stay (days) (median (IQR))	7 (6;9)	7 (6;10)

SD: standard deviation; IQR: interquartile range; CABG: Coronary artery bypass operation.

Valve replacement(s) (mechanical or biological replacement of the mitral or aortic valve, including patients with surgery on two valves (replacement and plasty)), Combined procedures (combination of CABG and valve replacement/plasty), Other (David n = 3, annuloplasty of the mitral valve n = 17, annuloplasty of the tricuspid valve n = 2, m + t plasty n = 2, myxoma and m-plasty n = 1, myxoma n = 3, composite graft n = 17, composite graft and m-plasty n = 2). Length-of-stay: the length of stay at index admission, including time at a local hospital.

^aPatients with forced expiratory volume, % ≤80 of the predicted value.

^bPatients with diabetes: insulin, per-oral or non-pharmacological treatment.

Table 2. Unplanned readmissions and all-cause mortality within one year.

	Intervention (n = 100)	Control (n = 319)	p-Value
Unplanned readmissions:
Patients readmitted, n (%)	32 (32)	95 (30)	0.71
-of these within 30 days, n (%)	22 (22)	57 (18)	0.38
Days from operation to first readmission, median (IQR)	23 (13;40)	20 (12;58)	0.84
Length of stay first readmission (days), median (IQR)	1 (1;3)	1 (0;3)	0.86
Cause of the first unplanned readmission, n (%^a)			0.68
Atrial fibrillation/flutter	2 (2)	6 (2)
Infection	3 (3)	18 (6)
Other causes presumed to be related to the surgery	9 (9)	19 (6)
Non-specific cardiac symptoms	10 (10)	35 (11)
Cardiac	6 (6)	16 (5)
All cause death, n (%)	1 (1)	1 (0.3)	0.42

n, number; IQR, interquartile range.

^aPercent of the total group.

Figure 2. Freedom from unplanned cardiac-related readmission.

Table 3. Pleurocenteses after discharge from the surgery.

	Intervention (n = 100)	Control (n = 319)	p-Value
Patients undergoing pleurocentesis after discharge (n (%))	17 (17)	25 (8)	0.01
Days from operation to first pleurocentesis (median (IQR))	16 (14;28)	25 (18;54)	0.04
Volume drained at the first pleurocentesis (mL)^a	900 (700;1500)	1275 (750;1600)	0.51
Side for pleurocentesis, n (%)			0.86
Right side	3 (18)	3 (12)
Left side	13 (76)	20 (80)
Both sides	1 (6)	2 (8)

n: number; IQR: interquartile range; mL: millilitre.

^aDrained volume was not reported for three patients in the control group.

Table 4. Self-reported health-related quality of life.

	Intervention group (n = 100)			Control group (n = 319)
Months after cardiac surgery, n	1	6	12	1	6	12
Answers within time, n (%)	83 (83)	79 (79)	81 (81)	223 (70)	215 (67)	227 (71)
Overall health (bad, %)	0	0	1	1	1	0
Overall well-being and quality of life (bad or very bad, %)	1	1	5	4	3	4
Not being able to control the important things in life (often or very often, %)	12	6	5	11	8	9
Difficulties sleeping or sleep problems (very bothered, %)	18	12	17	17	7	10
Ability to walk up more than one floor (very limited, %)	12	6	6	18	13	11
Time spend being very nervous during the last four weeks (all the time or most of the time, %)	6	3	1	4	2	4
Being sad during the last four weeks (all the time or most of the time, %)	5	1	1	4	4	3
Physical health or well-being has made it challenging to see other people during the last four weeks (all the time or most of the time, %)	5	3	1	11	1	2
Talking about health issues with health professionals (challenging or very difficult, %)	2	3	4	7	9	6

No statistical differences between groups when comparing individual changes in answers between months 1 and 6 and months 1 to 12 (Fischer’s exact test on categorical differences).