Evaluation of observation of the patients with coronary heart disease after surgical treatment

Abstract

Abstract Background To reduce mortality from cardiovascular diseases in Kazakhstan, which occupies the leading position, patients are under observation. To evaluate of patients with coronary artery disease who have undergone myocardial revascularization by installing coronary artery stenting or bypass surgery. Methods A retrospective analysis of outpatient medical records of patients. Results Analysis included medical records of 4% patients at the age of 40-49 years, 49%-50-59 years, 22%-60-69 years, 11%-70-79 years, 4% patients older than 80 year. 92% patients were admitted to the hospital with acute coronary syndrome and were urgently operated. Patients with chronic heart failure were operated routinely. 12% patients received surgical treatment twice, including 4% patients routinely. All patients had comorbidities: 63% of people-arterial hypertension, 12%-cardiac arrhythmia, 14%-diabetes. The analysis showed that only 51% of patients were regularly observed in accordance with the standards of the survey during one year of observation. According to the standards the scheduled ECG study of the patients after surgery should be done after 1, 2, 3 and 6 months. In accordance of the standard 23% patients were examined, 3 times a year - 19% patients, 23% people-twice a year. Other functional studies-echocardiography 1 time per year have been studied on 14% people, treadmill test-5% patients. Coagulation monitoring during one year- 46% patients. One of the criteria of proper observation is the number of readmissions. 11% patients were readmitted where 5% of them in the first month after surgery-6% patient with hypertensive crisis, 11%-with an increase of CHF, 2%-with postoperative pleural effusion. 2% patients hospitalized with restenosis after 7 months. Conclusions It should be noted that irregular visits to the doctor questioned the compliance of patients to treatment. Due to the lack of control by medical workers, the patients were not fully examined. Key messages The continuity of work between hospital doctors and primary care organizations is necessary. Patients to improve the favorable prognosis requires regular medication.