Background Coronary artery bypass graft (CABG) surgery is an invasive procedure done to resolve symptoms and improve quality of life in patients with coronary artery disease. However, it is a major operation that has its own complications and risks. Delayed extubation (DE) after surgery has been associated with higher-than-average rates of morbidity and mortality. The objective of this study was to determine the incidence and most important predictors of DE following CABG surgery.
Methods This prospective observational study was conducted on 300 adult patients who underwent non-urgent CABG. Data were collected from 4 hospitals in Alexandria, Egypt, by trained research assistants and were analyzed using logistic regression, independent t-testing, and Fisher's exact test.
Results Seventy-five participants (25%) developed DE. Patients with age ≥60 years, operation time ≥7 hours, cardiopulmonary bypass time ≥120 minutes, or body mass index ≥28 kg/m2 had a 1.71, 1.88, 2.25, or 2.33 times higher risk of developing DE than those in the counterpoint groups. The only protective variable was the ejection fraction (EF). Patients with EF ≥50% were 21% less likely to develop DE than those with EF less than 50%. Participants who developed DE stayed longer in the intensive care unit (mean±standard deviation [SD], 7.9±1.60 vs. 3.1±1.2; P<0.001) and in the hospital (mean±SD, 22.6±3.1 vs. 15.1±2.9; P<0.001) than those who did not develop DE.
Conclusions Performing CABG as early as possible, controlling body mass index, shortening the operation and cardiopulmonary bypass times, and enhancing EF might decrease the occurrence of postoperative DE and its associated mortality.
Background There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study’s purpose was to examine nurses’ knowledge and attitudes toward palliative care.
Methods A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data.
Results We measured nurses’ knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type.
Conclusions ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.
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