Share This Article:

Genuine Palestinian cabbage: Myth or fact. Comparison between Palestinian and Belgian coronary artery bypass grafting

Abstract Full-Text HTML Download Download as PDF (Size:661KB) PP. 50-61
DOI: 10.4236/wjcd.2013.34A008    3,399 Downloads   4,797 Views  

ABSTRACT

Background: Outcomes post-CABG serves as an indicator of the quality and effectiveness of care given by health care providers. The primary aim of this study is to describe outcomes such as mortality, morbidity, length of hospitalization and hospital readmission post-CABG between Ramallah Ministry of Health Hospital and Ghent University hospital. Methods: A retrospective study is conducted on 200 matched patients who underwent isolated CABG in Ramallah hospital and Ghent University hospital between 2009 and 2011. Both groups were followed up in the post-operative period for minimum one year. Inferential statistics were performed to find the presence of relationship among variables. Kaplan-Meyer was performed to compare overall survival rates and freedom from adverse events. The logistic model was used to assess all factors that associated with readmission, mortality, morbidity and hospital stay. Findings: Both groups had comparable patient characteristics and operative data. Risk factors of diabetes (50%) and smoking (60%) were higher in Palestinian patients compared to (29%) and (31%) in Belgian patients. The mortality rate slightly, being higher among the Palestinian group, was 4% compared to 2% among the Belgium group. Occurrence of morbidity was less noted among Palestinian patients compared to Belgium patients (23%, 36%, P = 0.044 respectively). Palestinian patients had shorter hospital stay (IQR = 6 - 10, P < 0.001). However, they had significantly higher rate of re-admission within 30 days of the operation (P = 0.007). Moreover, the overall infection experience in the Palestinian group was higher after adjustment for the confounding effect of smoking and diabetes (P = 0.046 and P = 0.042 respectively). In Ramallah hospital, diabetes (P = 0.011) and smoking (P = 0.012) were significantly associated with higher readmission rate. Interpretation: Finding indicates that although in-hospital adverse events didn’t statistically differ, 30-day mortality rate and re-admission were slightly higher among Palestinian patients, while the incidence of atrial fibrillation was increased and hospital stay was prolonged in the Belgium group. Diabetes and smoking in Palestinewere found to be independent risk factors for higher readmission rate and infection.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Salameh, B. , Darwazah, A. , Verhaaren, H. and Nooten, G. (2013) Genuine Palestinian cabbage: Myth or fact. Comparison between Palestinian and Belgian coronary artery bypass grafting. World Journal of Cardiovascular Diseases, 3, 50-61. doi: 10.4236/wjcd.2013.34A008.

References

[1] Cassar, A., Holmes, D.R., Rihal, C.S. and Gersh, B.J. (2009) Chronic coronary artery disease: Diagnosis and management. Mayo Clinic Proceedings, 84, 1130-1146. doi:10.4065/mcp.2009.0391
[2] Yusuf, S. (2004) Tackling the challenge of cardiovascular disease burden in developing countries. American Heart Journal, 148, 1-4. doi:10.1016/j.ahj.2004.03.045
[3] Gaziano, T.A., Bitton, A., Anand, S., Gessel, S.A. and Murphy, A. (2010) Growing epidemic of coronary heart disease in low-and middle income countries. Current Problems in Cardiology, 35, 72-115. doi:10.1016/j.cpcardiol.2009.10.002
[4] Gersh, B.J., Sliwa, S., Mayosi, B.M. and Yusef, S. (2010) The epidemic of cardiovascular disease in the developing world: Global implications. European Heart Journal, 31, 642-648. doi:10.1093/eurheartj/ehq030
[5] Hall, S.L. and Lorenc, T. (2010) Secondary prevention of coronary artery disease. American Family Physician, 81, 289-296.
[6] Martin, C.G. and Turkelson, S.L. (2006) Nursing care of the patient undergoing coronary artery bypass grafting. Journal of Cardiovascular Nursing, 21, 109-117.
[7] Aroney, C.N., Aylward, P., Kelly, A., Chew, D.P.B., Clune, E. and Acute Coronary Syndrome Guidelines Working Group. (2006) Guidelines for the management of acute coronary syndromes. Medical Journal of Australia, 184, S1-S29.
[8] Palestinian Ministry of Health. (2012) Statistical health reports. http://www.moh.ps
[9] Kark, J.D., Fink, R., Adler, B., Goldberger, N. and Goldman, S. (2006) The incidence of coronary heart disease among Palestinians and Israelis in Jerusalem. International Journal of Epidemiology, 35, 448-457. doi:10.1093/ije/dyl012
[10] Jabara, R., Namouz, S., Kark, J.D. and Lotan, C. (2007) Risk characteristics of Arab and Jewish women with coronary heart disease in Jerusalem. The Israel Medical Association Journal, 9, 316-320.
[11] Ministry of Health. (2012) National strategic health plan 2011-2013. http://www.moh.ps/attach/20.pdf
[12] Nashef, S.A., Roques, F., Michel, P., Gauducheau, E., Lemeshow, S. and Salamon, R. (1999) European system for cardiac operative risk evaluation (EuroSCORE). European Journal Cardio-Thoracic Surgery, 16, 9-13. doi:10.1016/S1010-7940(99)00134-7
[13] Nashef, S.A., Roques, F., Sharples, L.D., et al. (2012) EuroSCORE II. European Journal Cardio-Thoracic Surgery, 41,734-744. doi:10.1093/ejcts/ezs043
[14] Siregar, S., Groenwold, R.H.H., De Heer, F., et al. (2012) Performance of the original. European Journal CardioThoracic Surgery, 285, 1.
[15] Ettema, R.G.A., Peelen, L.M., Schuurmans, M.J., et al. (2010) Prediction models for prolonged intensive care unit stay after cardiac surgery: Systematic Review and validation study. Circulation, 122, 682-689. doi:10.1161/CIRCULATIONAHA.109.926808
[16] Parolari, A., Pesce, L.L., Trezzi M., et al. (2009) Performance of EuroSCORE in CABG and off-pump coronary artery bypass grafting: Single institution experience and meta-analysis. European Heart Journal, 30, 297-304. doi:10.1093/eurheartj/ehn581
[17] Jabara, R., Namouz, S., Kark, J.D. and Lotan, C. (2007) Risk characteristics of Arab and Jewish women with coronary heart disease in Jerusalem. The Israel Medical Association Journal, 9, 316-320.
[18] Jamee, A. and Abed, Y. (2012) Outcomes of cardiac surgery in the Gaza Strip, occupied Palestinian territory: A cross-sectional study. Lancet Palestinian Health Alliance Conference, 5-6 March 2012, Beirut, Lebanon, 380, S27.
[19] Hamad, M.A.S., Van Straten A.H.M., et al. (2010) Preoperative ejection fraction as a predictor of survival after coronary artery bypass grafting: Comparison with a matched general population. Journal of Cardiothoracic Surgery, 5, 29. doi:10.1186/1749-8090-5-29
[20] Mullen-Fortino, M. and O’Brien, N. (2009) Caring for a patient after coronary artery bypass graft surgery. Nursing Critical Care, 4, 22-27.
[21] Sun, X., et al. (2011) Comparison of frequency of atrial fibrillation after coronary artery bypass grafting in African Americans versus European Americans. The American Journal of Cardiology, 108, 669-672. doi:10.1016/j.amjcard.2011.04.013
[22] Robert, et al. (2002) The effect of comorbid illness on mortality outcomes in cardiac surgery. Archives of Surgery, 137,428-433. doi:10.1001/archsurg.137.4.428
[23] Mohammadi, S., et al. (2007) Long-term impact of diabetes and its comorbidities in patients undergoing isolated primary coronary artery bypass graft surgery. Circulation, 116, I102-I252.
[24] Batàr, S.C., Sarlea, S.V., Tigan, S.I. and Bàrsan, M. (2010) Gender and Diabetes Mortaliy Relevance on Outcomes of Coronary Artery Bypas Grafting. A retrospecttive study. Applied Medical Informatics, 26, 83-88.
[25] Al-Zaru, I.M., Ammouri, A.A., Al-Hassan, M.A. and Amr, A.A. (2010) Risk factors for deep sternal wound infections after cardiac surgery in Jordan. Journal of Clinical Nursing, 19, 1873-1881. doi:10.1111/j.1365-2702.2010.03193.x
[26] Ahmed, D., Chema, F.H., Ahmed, Y.I, et al. (2011) Incidence and predictors of infection in patients undergoing primary isolated coronary artery bypass grafting: A report from a tertiary care hospital in a developing country. The Journal of Cardiovascular Surgery (Torino), 52, 99-104.
[27] Cowper, P.A., et al. (2007) Is early too early? Effect of shorter stays after bypass surgery. The Annals of Thoracic Surgery, 83, 100-107. doi:10.1016/j.athoracsur.2006.08.001

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.