Key result
Integrated intensivist consultation is linked to reduced postoperative complications, ventilator time, and length of stay.
Why the study?
The impact of integrated intensivist consultation in the immediate postoperative period on outcomes for cardiac surgery patients was unclear.
Does integrated intensivist consultation reduce postoperative complications and mortality in adult cardiac surgery patients?
Cohort (n=1,711)
No
Does integrated intensivist consultation reduce postoperative complications and mortality in adult cardiac surgery patients?
Integrated intensivist consultation in the postoperative care of cardiac surgery patients reduces ventilator time, length of stay, and complications, though it does not improve survival.
Answers are grounded in this paper and cite their sources.
May shorten ventilation/LOS and reduce complications after cardiac surgery; hypothesis-generating for intensivist integration pending prospective confirmation.
This study examined the impact of integrated intensivist consultation in the immediate postoperative period on outcomes for cardiac surgery patients. A retrospective cohort study was conducted in 1711 adult cardiac surgery patients from a single quaternary care center in Minnesota. Outcomes were compared across 2 consecutive 2-year time periods reflecting an elective intensivist model (n = 801) and an integrated intensivist model (n = 910). Patients under the 2 models were comparable with respect to demographics, comorbidities, procedure types, and Society for Thoracic Surgery predicted risk of mortality score; however, patients in the earlier cohort were slightly older and more likely to have chronic kidney disease ( P = .003). Integrated intensivist involvement was associated with reduced postoperative ventilator time, length of stay (LOS), stroke, encephalopathy, and reoperations for bleeding (all P < .01) but was not associated with mortality. Intensivist integration into the postoperative care of cardiac surgery patients may reduce ventilator time, LOS, and complications but may not improve survival.
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Sultan et al. (2018) conducted a cohort in Cardiac surgery (n=1,711). Integrated intensivist model vs. Elective intensivist model was evaluated on Postoperative ventilator time, length of stay, stroke, encephalopathy, reoperations for bleeding, and mortality (p=<.01). Integrated intensivist consultation was associated with reduced postoperative ventilator time, length of stay, stroke, encephalopathy, and reoperations for bleeding (all P < .01).
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