Grolle, R. (Rosanne) (2016) De effecten op korte termijn van een preoperatieve multidisciplinaire interventie op patiënten die een electieve hartoperatie ondergaan. thesis, Medicine.
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Abstract
Summary Heart diseases are a great cause of burden of disease in the Netherlands and may lead to a cardiac surgery with risks of developing complications. In this retrospective observational study, the short-term effects of a preoperative, intensive, multidisciplinary cardiac rehabilitation program are investigated (the HRCTC-program: Cardiac Rehabilitation CardioThoracic Surgery). This regular care at the University Medical Center of Groningen (UMCG) consisted of physical therapy, consultation of a psychologist, a dietician and when applicable, coaching to stop smoking. Inclusion criteria were patients aged older than 18 years, admitted for a coronary artery bypass graft (CABG), valve surgery, aortic surgery or combinations of these three surgeries. Data until discharge from the UMCG was obtained from the BHN-database (‘Begeleidingscommissie Hartinterventie Nederland’). Between February 2015 and December 2015, 42 patients who participated in the HRCTC-program were included and compared to 84 controls who did not participate in a preoperative rehabilitation program. There were no significant differences between the two groups with respect to duration of stay at the intensive care unit (median 1 day, IQR (interquartile range) 1-1 in the HRCTC group vs median 1 day, IQR 1-1 in the controls, P=0.8640), mechanical ventilation >24 hours (7.1% vs 8.3%, P=0.816), hospital stay (median 7 days, IQR 6-11 vs median 7 days, IQR 6-8, P=0.6982), delirium (14.4% vs 15.5%, P=0.860), heart rhythm disorder (33.3% vs 41.7%, P=0.366), perioperative myocardial infarction (0% vs 4.8%, P=0.151), stroke with permanent injury (0% vs 1.2%, P=0.478), stroke without permanent injury (2.4% vs 1.2%, P=0.614), pneumonia (4.8% vs 7.1%, P=0.605), mediastinitis (2.4% vs 3.4%, P=0.719), rethoracotomy (7.1% vs 3.6%, P=0.375) or in-hospital death (2.4% vs 2.4%, P=1.000). These results show no differences between the two groups. The HRCTC-program is anyway non-inferior to compared to the control. For future research, it is important to create a bigger sample size to improve power, to randomize and prolong follow-up time.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Mariani, Prof. Dr. M. and Tweede begeleider: and Hartog, Drs. J. and UMCG Groningen, thoraxchirurgie. Onderdeel van de Heart-ROCQ |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:43 |
| Last Modified: | 25 Jun 2020 10:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/473 |
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