Complications and hospital length of stay in coronary artery bypass graft surgery in public hospitals in Rio de Janeiro.
OBJECTIVE
To evaluate associations between post-operative complications in patients who survive surgery and in-hospital deaths and lengths of hospital stays of patients who undergo coronary artery bypass graft surgery


METHODS
Patients who underwent coronary artery bypass graft surgery and survived the operating theater were randomly selected. Information on complications and hospital lengths of stay until hospital discharge or death were retrospectively collected based on medical records and declarations of death. These aspects were estimated according to the presence of complications, frequency of complications, mortality, relative risk and attributable population risk. Mean hospital lengths of stay were compared using Wald's statistics.


RESULTS
Medical records indicating deaths in the operating theater were excluded, and 86.9% of the included records reported complications; the greatest loss of information (43.9%) was related to kidney failure. Hyperglycemia was estimated as the most frequent complication (74.6%), with an attributable risk of 31.6%. The population's attributable risks were greater than 60% for low cardiac output (77.0%), kidney failure (64.3%) and cardiorespiratory failure (60.4%). Twelve different situations were identified for paired combinations of significant differences between average post-operative hospitalization times and complications, according to the outcome of discharge or death.


CONCLUSIONS
Several complications were identified during the postoperative period of coronary artery bypass graft surgery, with different frequencies and impacts on mortality. Control of the myocardium at the risk of ischemia, hemodynamic stabilization and volume replacement strategies may be effective for controlling mortality rates and shortening hospital lengths of stay.
Marcio Roberto Moraes de
MR
Carvalho
Nelson Albuquerque de Souza E
NA
Silva
Gláucia Maria Moraes de
GM
Oliveira
Carlos Henrique
CH
Klein