Postoperative risk assessment of MI and nursing workload in ICU patients

Background: The high cost of care and the increased mortality of patients undergoing non-cardiac surgery with myocardial ischemia (MI) dictate the monitoring of the nursing workload (NWL) and its correlation with outcomes such as mortality in intensive care unit (ICU).

Aim: The application of the Nursing Activities Score in patients who underwent non-cardiac surgery and developed myocardial ischemia in the ICU.

Material and Method: The study was conducted in a general ICU, in a sample of 105 adult patients. Data collection was performed by the use of three instruments:(a) The Nursing Activities Score (NAS), (b) the revised cardiac risk index (Lee Index), and c) the CHA2DS2-VASc score. The correlation of MI and mortality with NWL, and other preoperative variables was studied. The significance levels are bilateral and the statistical significance was set at 0.05. The statistical program SPSS 22.0 was used for the analysis.

Results: MI rates were significantly higher in patients with comorbidities (p <0.015). Higher CHA2VASC2 score was associated with a significantly higher probability of MI. In the 1st 24 hours the NWL was similar in all cases (p = 0.947). At the 2nd and 3rd 24 hours the NWL was significantly higher in patients with MI (p <0.001). The NWL was significantly higher in patients with MI who died in all 24 hours.

Conclusions: The increased severity of the clinical condition of postoperative patients with MI, but also the lack of studies to investigate NWL in these patients indicate the need for further research.

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