Structural and Process Factors Associated with 30-Day Postoperative Complication Severity After Open-Heart Surgery: A Single-Center Observational Study.
- 1Faculty of Nursing, Mahidol University, Bangkok, Thailand.
- 2Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Abstract
Open-heart surgery is associated with substantial postoperative morbidity. Guided by the Nursing Role Effectiveness Model, this study focused on the severity of 30-day postoperative complications rather than only the presence or absence of complications. The study examined structural factors (health literacy, nutritional status, severity of comorbidities, anemia, and surgical mortality risk) and process factors (perception of patient-centered care, type of surgery, and cardiopulmonary bypass time) associated with complication severity after open-heart surgery. A prospective, single-center observational prognostic factor study with medical record review was conducted from June 2022 to July 2023 among 136 adult patients undergoing open-heart surgery at a tertiary hospital in Thailand. Data were collected from patient questionnaires and medical records. The primary outcome was 30-day complication severity measured using the Comprehensive Complication Index. Bivariate analyses and multiple linear regression were performed, with prespecified covariates selected based on clinical relevance. Participants had a mean age of 61.32 years (SD = 13.09), and 61.8% were male. The mean Comprehensive Complication Index score was 37.25 (SD = 14.70). In the adjusted model, surgical mortality risk (standardized beta = 0.345, p < 0.001), anemia (standardized beta = 0.224, p = 0.018), nutritional status (standardized beta = -0.218, p = 0.011), and cardiopulmonary bypass time (standardized beta = 0.198, p = 0.034) were independently associated with complication severity. Health literacy, comorbidity severity, and perceived patient-centered care were not statistically significant. Surgical mortality risk, anemia, nutritional status, and cardiopulmonary bypass time were key factors associated with 30-day complication severity. These findings support preoperative optimization of hematological and nutritional status and careful intraoperative management to reduce postoperative morbidity; however, interpretation should consider the single-center design and available covariates.
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BibTeX
@article{nakkhamhaeng2026structural,
title = {{Structural and Process Factors Associated with 30-Day Postoperative Complication Severity After Open-Heart Surgery: A Single-Center Observational Study.}},
author = {Sirinapha Nakkhamhaeng and Ketsarin Utriyaprasit and Thitipong Tankumpuan and Napaporn Wanitkun and Teerapong Tocharoenchok},
journal = {Journal of multidisciplinary healthcare},
year = {2026},
month = nov,
doi = {10.2147/jmdh.s598783},
url = {https://europepmc.org/article/MED/42997429},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Structural and Process Factors Associated with 30-Day Postoperative Complication Severity After Open-Heart Surgery: A Single-Center Observational Study.
AU - Sirinapha Nakkhamhaeng
AU - Ketsarin Utriyaprasit
AU - Thitipong Tankumpuan
AU - Napaporn Wanitkun
AU - Teerapong Tocharoenchok
PY - 2026
DA - 2026/11/02
JO - Journal of multidisciplinary healthcare
DO - 10.2147/jmdh.s598783
UR - https://europepmc.org/article/MED/42997429
AB - Open-heart surgery is associated with substantial postoperative morbidity. Guided by the Nursing Role Effectiveness Model, this study focused on the severity of 30-day postoperative complications rather than only the presence or absence of complications. The study examined structural factors (health literacy, nutritional status, severity of comorbidities, anemia, and surgical mortality risk) and process factors (perception of patient-centered care, type of surgery, and cardiopulmonary bypass time) associated with complication severity after open-heart surgery. A prospective, single-center observational prognostic factor study with medical record review was conducted from June 2022 to July 2023 among 136 adult patients undergoing open-heart surgery at a tertiary hospital in Thailand. Data were collected from patient questionnaires and medical records. The primary outcome was 30-day complication severity measured using the Comprehensive Complication Index. Bivariate analyses and multiple linear regression were performed, with prespecified covariates selected based on clinical relevance. Participants had a mean age of 61.32 years (SD = 13.09), and 61.8% were male. The mean Comprehensive Complication Index score was 37.25 (SD = 14.70). In the adjusted model, surgical mortality risk (standardized beta = 0.345, p < 0.001), anemia (standardized beta = 0.224, p = 0.018), nutritional status (standardized beta = -0.218, p = 0.011), and cardiopulmonary bypass time (standardized beta = 0.198, p = 0.034) were independently associated with complication severity. Health literacy, comorbidity severity, and perceived patient-centered care were not statistically significant. Surgical mortality risk, anemia, nutritional status, and cardiopulmonary bypass time were key factors associated with 30-day complication severity. These findings support preoperative optimization of hematological and nutritional status and careful intraoperative management to reduce postoperative morbidity; however, interpretation should consider the single-center design and available covariates.
SN - 1178-2390
ER -