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  1. In the queue for coronary artery bypass grafting : patients'perceptions of risk and'maximal acceptable waiting time.

    Article - En anglais

    Objectives 

    To elicit patients'maximal acceptable waiting times (MAWT) for non-urgent coronary artery bypass grafting (CABG), and to determine if MAWT is related to prior expectations of waiting times, symptom burden, expected relief, or perceived risks of myocardial infarction while waiting.

    Methods 

    Seventy-two patients on an elective CABG waiting list chose between two hypothetical but plausible options : a 1-month wait with 2% risk of surgical mortality, and a 6-month wait with 1% risk of surgical mortality.

    Waiting time in the 6-month option was varied up if respondents chose the 6-month/lower risk option, and down if they chose the 1-month/higher risk option, until the MAWT switch point was reached.

    Patients also reported their expected waiting time, perceived risks of myocardial infarction while waiting, current function, expected functional improvement and the value of that improvement.

    Results 

    Only 17 (24%) patients chose the 6-month/1% risk option, while 55 (76%) chose the 1-month/2% risk option.

    The median MAWT was 2 months ; scores ranged from 1 to 12 months (with two outliers).

    Many pereceived high cumulative risks of myocardial infarction if waiting for 1 (upper quartile,>1.45%) or 6 (upper quartile,>10%) months.

    However, MAWTscores were related only to expected waiting time (r=0.47 ; P<0.0001).

    Conclusions 

    Most patients reject waiting 6 months for elective CABG, even if offered along with a halving in surgical mortality (from 2% to 1%). (...)

    Mots-clés Pascal : Appareil circulatoire, Risque, Epidémiologie, Variable, Perception, Accessibilité, Soin, Analyse risque

    Mots-clés Pascal anglais : Circulatory system, Risk, Epidemiology, Variable, Perception, Accessibility, Care, Risk analysis

    Notice produite par :
    ORS Auvergne - Observatoire Régional de la Santé d'Auvergne

    Code Inist : 002B30A11. Création : 06/10/1999.