UK study reveals worrying survival gap between rich and poor after heart surgery

People from the most deprived areas of England have a far higher risk of death after cardiac surgery than people from the least deprived areas, finds a large study published on bmj.com today. Cardiovascular disease is the commonest cause of early death in the Western world and is closely related to social and economic deprivation. Cardiac surgery has significant benefits, but it is not clear whether they apply equally to all patients, irrespective of their social and economic circumstances. So a team of researchers set out to assess the effects of social deprivation on survival following a range of cardiac surgical procedures. They analysed data on 44,902 patients, with an average age of 65 years, who underwent cardiac surgery between 1997 and 2007 at five hospitals in Birmingham and North West England. Social deprivation was calculated for all patients based on their postcode at the 2001 census for England and Wales. A total of 1,461 patients (3.25%) died in hospital following their surgery and 5,563 patients (12.4%) died during five year follow-up. Social deprivation was a strong independent predictor of death - Science Centric

Nurses across Canada are reducing wait times

"A new treatment regime initiated by a clinical nurse specialist in New Westminster, B.C., means cardiac surgery patients have fewer complications and spend less time in hospital. A nurse-managed outpatient chemotherapy clinic in Toronto decreases wait times for treatment. Intervention from a nurse practitioner reduces the need for hospitalization for long-term care residents across Ontario. Nurses working collaboratively with physicians has almost doubled the capacity of some family practices in Halifax. These are just a few examples of how registered nurses are developing innovative solutions to the challenges of wait times, as outlined in Registered Nurses: On the Front Lines of Wait Times, a paper the Canadian Nurses Association has released to coincide with the Taming of the Queue conference on March 26-27 in Ottawa. Concern about wait times in Canada has increased over the last decade to become the most important health-care issue among the Canadian public and health-care providers (Health Care in Canada Survey, 2007)." - CNW

Michigan collaboration saves lives, improves outcomes for heart surgery patients

A collaboration among the Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS), Michigan hospitals, and Blue Cross Blue Shield of Michigan (BCBSM) is facilitating improved outcomes in cardiac surgery and decreasing complications and costs in Michigan - Yahoo Finance

Statins may reduce odds of delirium after cardiac surgery

"A new study has provided some of the first evidence that the use of cholesterol-lowering statins before cardiac surgery decreases the odds of postoperative delirium in elderly patients. Previous studies have shown that statins reduce the incidence of morbidity and mortality after cardiac and major non-cardiac surgery. Statins have also been shown to be protective in central nervous system injury. The study is published in the January 2009 issue of Anesthesiology" - ANI

Risk of death may be higher with drug commonly used during cardiac surgery

"The risks of death are probably higher with aprotinin, a drug commonly used to control blood loss and transfusions during cardiac surgery, compared with lysine analogues, according to a study to be published in the 20th January issue of CMAJ" - Science Centric

U.S. hospitals ease crowded ERs with beds in halls

"There's no phone and no television. Only a screen offers privacy. But heart patient Edward Gray understands why the hospital put him in a cardiac unit hallway. 'They sent me up here to make room for other emergency patients,' Gray, 78, said last week from his bed in the hall of a New York area hospital. 'This is the way things are in hospitals.' It may not sound like ideal health care, but hospital officials nationwide are being urged to consider hallway medicine as a way to ease emergency department crowding, and some are trying it. Leading the way is Stony Brook University Medical Center in Stony Brook, N.Y., where a study found that no harm was caused by moving emergency room patients to upper-floor hallways when they were ready for admission" - Chicago Tribune

Residents' performance in cardiac surgery on par with that of staff surgeons

"For patients undergoing cardiac surgery, long-term outcomes were similar whether a resident or a staff surgeon did the procedure, a single-center study found. Having a resident as the primary surgeon was not associated with death or readmission for cardiovascular reasons through a median of 2.7 years after coronary artery bypass graft (CABG), aortic valve replacement, or both (HR 1.05, 95% CI 0.94 to 1.17, P=0.42), according to Roger Baskett, M.D., of the Maritime Heart Center at Dalhousie University" - MedPage Today