Examining symptom trajectories that predict worse outcomes in post-CABG patients.
Ming-Fen Tsai, Shiow-Luan Tsay, Debra Moser and 2 others
PMID 30379108WHAT IT FOUND
In 198 post-CABG patients, symptoms did not improve the same way for everyone.
Older age, longer ICU stay, fewer bypassed vessels, smoking and no regular exercise marked those likely to have persistent angina, breathlessness, fatigue, depression, sleep or anxiety problems.
Key findings
01In 198 first-time CABG patients, six common symptoms did not follow one recovery path; each had separate trajectory classes.
02Worse angina trajectory was associated with longer ICU stay, while on-pump CABG was associated with quicker angina recovery.
03Older age, longer ICU stay, fewer vessels bypassed, smoking and no regular exercise were linked to worse symptom trajectories for breathlessness, fatigue, depression, sleep or anxiety.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an observational study, so it cannot show that age, ICU stay, vessels bypassed, smoking or exercise caused worse symptom trajectories. The sample was from Taiwan, and the authors note that the findings may not generalise beyond that setting or culture. Some symptom scores were low, which may make trajectory estimates less reliable. Surgical complications were rare and not included in the analysis, so their effect on trajectories is unclear. The study tested no treatment, so it does not show that education, breathing exercises or monitoring improve outcomes.
Declared interests
The authors declared no conflict of interest and said the research received no specific grant from any public, commercial or not-for-profit sector.
The easy way to misread this
Do not read these associations as proof that older age, longer ICU stay, fewer bypassed vessels, smoking or lack of exercise cause poor recovery. The study did not test any intervention, so it cannot show that breathing exercises, monitoring or education improve trajectories.