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

Basma Salameh, Ahmad K. Darwazah, Henri Verhaaren, Guido Van Nooten

Department of Cardiac Surgery, University Hospital Ghent, Ghent, Belgium.
Doctoral School, Department of Medical-Social Science, Ghent University, Ghent, Belgium.
Ghent University, Ghent, Belgium.
Head of Department of Cardiac Surgery, Ramallah Hospital, Consultant Cardiac Surgeon, Makassed Hospital, Jerusalem, Palestine.

DOI: 10.4236/wjcd.2013.34A008                

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.

Keywords

CABG; Mortality; Morbidity; Length of Hospitalization; Re-Admission; Atrial Fibrillation;

Conflicts of Interest

The authors declare no conflicts of interest.

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