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September 18, 2001CirculationOpen Access

Waiting for Cardiac Surgery

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Why the study?

Does prolonged waiting time for cardiac surgery increase the hazard of waiting or worsen surgical outcomes in patients queued for CABG or aortic valve replacement?

Population

2102 consecutive patients queued for CABG, aortic valve replacement, or CABG+aortic valve replacement…

Comparison

Prioritization to 1 of 4 queues for cardiac… vs Different waiting times based on queue priority

Design

Cohort

Authors

ARA. Andrew RayLoma Linda University Medical CenterKBKaren J. ButhDalhousie UniversityJSJohn A. SullivanDalhousie University

Discussion

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Implication

Supports safety of prioritized CABG/AVR waiting lists; leaves open optimal triage to reduce early mortality and upgrades.

Structured PICO

Does prolonged waiting time for cardiac surgery increase the hazard of waiting or worsen surgical outcomes in patients queued for CABG or aortic valve replacement?

P
Population
2102 consecutive patients queued for CABG, aortic valve replacement, or CABG+aortic valve replacement between January 1, 1998, and December 31, 1999
I
Intervention
Prioritization to 1 of 4 queues (in-house urgent, semiurgent A, semiurgent B, elective) for cardiac surgery
C
Comparator
Different waiting times based on queue priority
O
Outcome
Hazard of waiting (death during waiting period) and impact of waiting on surgical outcomes (postoperative complications, operative mortality, length of stay)hard clinical

Prolonged waiting for cardiac surgery in a prioritized queue system is not associated with worse surgical outcomes, though deaths and clinical deterioration requiring upgrades occur early in the waiting period.

Cite This Study

Ray et al. (2001) studied this question.

synapsesocial.com/papers/6a71efa275498292b70b3b8ahttps://doi.org/10.1161/circ.104.suppl_1.i-92
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Analysis of deaths while waiting for cardiac surgery among 29 293 consecutive patients in Ontario, Canada1998 · 85 citations
  2. 2Priority points and cardiac events while waiting for coronary bypass surgery1999 · 67 citations
  3. 3Complications prior to revascularization among patients waiting for coronary artery bypass grafting and percutaneous transluminal coronary angioplasty1996 · 34 citations
  4. 4Assessing the Outcomes of Coronary Artery Bypass Graft Surgery: How Many Risk Factors Are Enough? fn1fn1Dr. Naylor is supported by a Career Scientist Award from the Ontario Ministry of Health, Toronto, Ontario, Canada. This work was supported by an operating grant from the Sunnybrook Trust for Medical Research, North York, Ontario, Canada.fn2fn2To discuss this article on-line, visit the ACC Home page at www.acc.org/membersand click on the JACC Forum1997 · 135 citations
  5. 5Coronary Artery Bypass Graft Surgery in Ontario and New York State: Which Rate Is Right?1997 · 74 citations