Surgical day of coronary artery bypass graft: its impact on frequency of physiotherapy intervention and patient outcomes

Affiliated institutions include: St. Michael's Hospital (L. Beavers, J. Colemane, P. Fox, J. Parks, S. Yue), University of Toronto (K. Berg)Purpose: To examine the pre-operative characteristics and post-operative outcomes among coronary artery bypass graft (CABG) patients that experience post-operative complications. To investigate the frequency of physiotherapy (PT) intervention and potential differences in patient outcomes based on surgical day of the week among on-pathway CABG patients. Method: A retrospective chart review was conducted for 333 patients who underwent CABG surgery at St. Michael s Hospital from May 1, 2007 through April 30, 2008. Data were collected using a data extraction form and quantitative analyses were performed to determine differences in pre-operative characteristics and post-operative patient outcomes between groups. Results: The off-pathway group presented with more comorbidities and poorer post-operative outcomes. No difference in frequency of PT intervention was observed among on-pathway patients that received surgery early versus late in the week. Conclusions: The presence of baseline differences suggests it is possible to identify at-risk patients earlier and intervene pre-operatively. If pre-operative interventions are further developed and shown to be beneficial, they may prevent longer hospital stays following CABG surgery. No suggestions can be made at this time to shift post-operative PT services for on-pathway patients to pre-operative initiatives at SMH