DEVELOPMENT OF AN ALGORITHM FOR DISPENSARY OBSERVATION OF PATIENTS WHO UNDERWENT CORONARY ARTERY BYPASS GRAFTING
Introduction. Studies indicate that almost 9.4% of patients who have undergone coronary artery bypass grafting (CABG) are re-hospitalized within 30 days after surgery [60].
The absence of outpatient visits to a PHC doctor within 30 days after discharge was associated with a fivefold increase in the risk of one-year functional survival (risk coefficient 5.18, p < 0.01) [60].
According to the recommendations of the American Heart Association (ANA/ACC), patients who have undergone CABG need special secondary prevention after discharge from the hospital (control of antiplatelet and lipid-lowering therapy) [25].
Currently, Kazakhstan does not provide dispensary monitoring of patients who have undergone CABG. Patients suffering from ischemic heart disease (unstable angina, angina pectoris, myocardial infarction) are not divided into those who underwent surgical treatment (CABG, stenting) and patients undergoing conservative therapy.
Objective: Analysis of the literature, clinical and epidemiological data and the existing system for organizing outpatient care at the post-hospital stage for patients undergoing CABG.
Search strategy. A literature review was conducted on the study of dispensary observation of patients who underwent CABG, Search depth 10 years. Search keywords for full-text open access articles in the PubMed database: coronary artery bypass grafting, medical examination, follow-up after CABG, recovery. The algorithm of dispensary observation. Inclusion criteria: Publications of the level of evidence A, B: meta-analyses, systematic reviews, cohort and cross-sectional studies. Exclusion criteria: expert opinion in the form of messages, advertising articles.
Results. It has been shown that patients who do not receive follow-up primary care have worse long-term outcomes. Many complications after CABG surgery are associated with a systemic inflammatory reaction associated with artificial blood circulation. Primary care practitioners play an important role in the recognition of CABG complications and postoperative care.
Conclusions: Thus, it is necessary to develop an algorithm for dispensary monitoring of patients after CABG.
Taimaz K. Tleuberlin 1, https://orcid.org/0000-0003-1720-2197
Natalya E. Glushkova2, https://orcid.org/0000-0003-1400-8436
Nadira N. Aitambayeva3, https://orcid.org/0000-0001-5869-1789
Sabit M. Zhussupov4, https://orcid.org/0000-0002-0551-126Х
Rustem S. Kazangapov4, https://orcid.org/0000-0003-1513-7432
Samatbek T. Abdrakhmanov5, https://orcid.org/0000-0002-4270-3498
1 Kazakhstan Medical University “Kazakhstan School of Public Health”, Department of Public Health and Social Sciences, Almaty, Republic of Kazakhstan;
2 Al-Farabi Kazakh National University, Department of Epidemiology, Biostatistics and Evidence Based Medicine, Almaty, Republic of Kazakhstan.
3 Kazakhstan Medical University “Kazakhstan School of Public Health”, Department of Public Health and Social Sciences, Almaty, Republic of Kazakhstan;
4 Pavlodar branch of NCJSC «Semey Medical University», Pavlodar city, Republic of Kazakhstan;
5 Semey Medical University, Semey, Republic of Kazakhstan;
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Tleuberlin T.K., Glushkova N.E., Aitambayeva N.N., Zhussupov S.M., Kazangapov R.S., Abdrakhmanov S.T. Development of an algorithm for dispensary observation of patients who underwent coronary artery bypass grafting // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 5, pp. 231-240. doi 10.34689/SH.2023.25.5.029Related publications:
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