Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients
Objectisves The purpose of this study was to identify the independent risk factors for fast-track failure (FTF) in cardiac surgery patients. Design A retrospective analysis. Setting A university-affiliated heart center. Participants In a 2-year period, 1,704 consecutive preselected patients undergoi...
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| Veröffentlicht in: | Journal of cardiothoracic and vascular anesthesia 2015-12, Vol.29 (6), p.1461-1465 |
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| container_title | Journal of cardiothoracic and vascular anesthesia |
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| creator | Zakhary, Waseem, MD Lindner, Jacob, MD Sgouropoulou, Sophia, MD Eibel, Sarah, MD Probst, Stefan, MD Scholz, Markus, PhD Ender, Joerg, MD |
| description | Objectisves The purpose of this study was to identify the independent risk factors for fast-track failure (FTF) in cardiac surgery patients. Design A retrospective analysis. Setting A university-affiliated heart center. Participants In a 2-year period, 1,704 consecutive preselected patients undergoing elective cardiac surgery were treated according to the local fast-track protocol in the postanesthetic care unit (PACU), bypassing the intensive care unit (ICU). Measurements and Results Independent risk factors for FTF in the univariate regression analysis were tested in a multivariate regression analysis. FTF was defined as any transfer of the preselected patient to the ICU. FTF was primary when the patient was transferred directly from the postanesthetic care unit to the ICU and secondary when the patient was transferred from the intermediate care unit or ward to the ICU. FTF rate was 11.6% for primary and 5.6% for secondary FTF. In the multivariate regression analysis, age>70 years, female sex, prolonged surgery, and prolonged cross-clamp time could be defined as independent risk factors for FTF. Conclusions In a preselected patient population, fast-track treatment could be done with a low FTF rate. Independent risk factors for FTF are age, female sex, prolonged surgery, and prolonged cross-clamp time. |
| doi_str_mv | 10.1053/j.jvca.2015.05.193 |
| format | Article |
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Design A retrospective analysis. Setting A university-affiliated heart center. Participants In a 2-year period, 1,704 consecutive preselected patients undergoing elective cardiac surgery were treated according to the local fast-track protocol in the postanesthetic care unit (PACU), bypassing the intensive care unit (ICU). Measurements and Results Independent risk factors for FTF in the univariate regression analysis were tested in a multivariate regression analysis. FTF was defined as any transfer of the preselected patient to the ICU. FTF was primary when the patient was transferred directly from the postanesthetic care unit to the ICU and secondary when the patient was transferred from the intermediate care unit or ward to the ICU. FTF rate was 11.6% for primary and 5.6% for secondary FTF. In the multivariate regression analysis, age>70 years, female sex, prolonged surgery, and prolonged cross-clamp time could be defined as independent risk factors for FTF. Conclusions In a preselected patient population, fast-track treatment could be done with a low FTF rate. Independent risk factors for FTF are age, female sex, prolonged surgery, and prolonged cross-clamp time.</description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1053/j.jvca.2015.05.193</identifier><identifier>PMID: 26342271</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Anesthesia & Perioperative Care ; cardiac anesthesia ; cardiac surgery ; Cardiac Surgical Procedures - adverse effects ; Cardiac Surgical Procedures - methods ; Critical Care ; fast track ; fast-track failure ; fast-track protocol ; Female ; Humans ; intensive care unit ; Male ; Middle Aged ; Patient Selection ; Postoperative Care - methods ; Postoperative Complications - epidemiology ; Postoperative Complications - prevention & control ; postoperative ventilation ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Failure</subject><ispartof>Journal of cardiothoracic and vascular anesthesia, 2015-12, Vol.29 (6), p.1461-1465</ispartof><rights>The Authors</rights><rights>2015 The Authors</rights><rights>Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c595t-32ec2b1e470fad31db8a35b9d11ee08c04a87210f7550641f5a9d1a34eb3e4e3</citedby><cites>FETCH-LOGICAL-c595t-32ec2b1e470fad31db8a35b9d11ee08c04a87210f7550641f5a9d1a34eb3e4e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.jvca.2015.05.193$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26342271$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zakhary, Waseem, MD</creatorcontrib><creatorcontrib>Lindner, Jacob, MD</creatorcontrib><creatorcontrib>Sgouropoulou, Sophia, MD</creatorcontrib><creatorcontrib>Eibel, Sarah, MD</creatorcontrib><creatorcontrib>Probst, Stefan, MD</creatorcontrib><creatorcontrib>Scholz, Markus, PhD</creatorcontrib><creatorcontrib>Ender, Joerg, MD</creatorcontrib><title>Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description>Objectisves The purpose of this study was to identify the independent risk factors for fast-track failure (FTF) in cardiac surgery patients. Design A retrospective analysis. Setting A university-affiliated heart center. Participants In a 2-year period, 1,704 consecutive preselected patients undergoing elective cardiac surgery were treated according to the local fast-track protocol in the postanesthetic care unit (PACU), bypassing the intensive care unit (ICU). Measurements and Results Independent risk factors for FTF in the univariate regression analysis were tested in a multivariate regression analysis. FTF was defined as any transfer of the preselected patient to the ICU. FTF was primary when the patient was transferred directly from the postanesthetic care unit to the ICU and secondary when the patient was transferred from the intermediate care unit or ward to the ICU. FTF rate was 11.6% for primary and 5.6% for secondary FTF. In the multivariate regression analysis, age>70 years, female sex, prolonged surgery, and prolonged cross-clamp time could be defined as independent risk factors for FTF. Conclusions In a preselected patient population, fast-track treatment could be done with a low FTF rate. Independent risk factors for FTF are age, female sex, prolonged surgery, and prolonged cross-clamp time.</description><subject>Aged</subject><subject>Anesthesia & Perioperative Care</subject><subject>cardiac anesthesia</subject><subject>cardiac surgery</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Critical Care</subject><subject>fast track</subject><subject>fast-track failure</subject><subject>fast-track protocol</subject><subject>Female</subject><subject>Humans</subject><subject>intensive care unit</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Postoperative Care - methods</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>postoperative ventilation</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Failure</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFq3DAQhkVpadKkL9BD8bEXuzOSFa2hFMrStIFAl2R7FrI0DnK81layA3vps1dm01JyyEUapG_-QZ8Ye4dQIUjxsa_6B2sqDigrkBU24gU7RSl4uao5f5nrTJWgFJywNyn1AIhSqtfshF-ITCg8Zb-vRkd7yss4FTc-3ReXxk4hpqILMddpKrfR2OXYD3Ok4mfy411hik0kR50fyf1PbWKYgg1D4ceFSDSQnTKyNtF5Y4vbOd5RPBQbM_k8MZ2zV50ZEr193M_Y9vLrdv29vP7x7Wr95bq0spFTKThZ3iLVCjrjBLp2ZYRsG4dIBCsLtVkpjtApKeGixk6afGdETa2gmsQZ-3CM3cfwa6Y06Z1PlobBjBTmpFFJbJpaNiqj_IjaGFKK1Ol99DsTDxpBL0J1rxftetGuQeqsPTe9f8yf2x25fy1_PWfg0xGg_MgHT1EnmwVYcj5mQ9oF_3z-5yftdvCjt2a4pwOlPsxxzPo06sQ16NslZ_l3lAASBIg_rfOpUw</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Zakhary, Waseem, MD</creator><creator>Lindner, Jacob, MD</creator><creator>Sgouropoulou, Sophia, MD</creator><creator>Eibel, Sarah, MD</creator><creator>Probst, Stefan, MD</creator><creator>Scholz, Markus, PhD</creator><creator>Ender, Joerg, MD</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20151201</creationdate><title>Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients</title><author>Zakhary, Waseem, MD ; Lindner, Jacob, MD ; Sgouropoulou, Sophia, MD ; Eibel, Sarah, MD ; Probst, Stefan, MD ; Scholz, Markus, PhD ; Ender, Joerg, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c595t-32ec2b1e470fad31db8a35b9d11ee08c04a87210f7550641f5a9d1a34eb3e4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Anesthesia & Perioperative Care</topic><topic>cardiac anesthesia</topic><topic>cardiac surgery</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Critical Care</topic><topic>fast track</topic><topic>fast-track failure</topic><topic>fast-track protocol</topic><topic>Female</topic><topic>Humans</topic><topic>intensive care unit</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Selection</topic><topic>Postoperative Care - methods</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>postoperative ventilation</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zakhary, Waseem, MD</creatorcontrib><creatorcontrib>Lindner, Jacob, MD</creatorcontrib><creatorcontrib>Sgouropoulou, Sophia, MD</creatorcontrib><creatorcontrib>Eibel, Sarah, MD</creatorcontrib><creatorcontrib>Probst, Stefan, MD</creatorcontrib><creatorcontrib>Scholz, Markus, PhD</creatorcontrib><creatorcontrib>Ender, Joerg, MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zakhary, Waseem, MD</au><au>Lindner, Jacob, MD</au><au>Sgouropoulou, Sophia, MD</au><au>Eibel, Sarah, MD</au><au>Probst, Stefan, MD</au><au>Scholz, Markus, PhD</au><au>Ender, Joerg, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2015-12-01</date><risdate>2015</risdate><volume>29</volume><issue>6</issue><spage>1461</spage><epage>1465</epage><pages>1461-1465</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>Objectisves The purpose of this study was to identify the independent risk factors for fast-track failure (FTF) in cardiac surgery patients. Design A retrospective analysis. Setting A university-affiliated heart center. Participants In a 2-year period, 1,704 consecutive preselected patients undergoing elective cardiac surgery were treated according to the local fast-track protocol in the postanesthetic care unit (PACU), bypassing the intensive care unit (ICU). Measurements and Results Independent risk factors for FTF in the univariate regression analysis were tested in a multivariate regression analysis. FTF was defined as any transfer of the preselected patient to the ICU. FTF was primary when the patient was transferred directly from the postanesthetic care unit to the ICU and secondary when the patient was transferred from the intermediate care unit or ward to the ICU. FTF rate was 11.6% for primary and 5.6% for secondary FTF. In the multivariate regression analysis, age>70 years, female sex, prolonged surgery, and prolonged cross-clamp time could be defined as independent risk factors for FTF. Conclusions In a preselected patient population, fast-track treatment could be done with a low FTF rate. Independent risk factors for FTF are age, female sex, prolonged surgery, and prolonged cross-clamp time.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26342271</pmid><doi>10.1053/j.jvca.2015.05.193</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anesthesia & Perioperative Care cardiac anesthesia cardiac surgery Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - methods Critical Care fast track fast-track failure fast-track protocol Female Humans intensive care unit Male Middle Aged Patient Selection Postoperative Care - methods Postoperative Complications - epidemiology Postoperative Complications - prevention & control postoperative ventilation Retrospective Studies Risk Factors Time Factors Treatment Failure |
| title | Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients |
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