Abstract
OBJECTIVE: This study aimed to investigate the effects of a continuous comprehensive nursing (CCN) system compared to routine care on postoperative hemoglobin (Hb) levels and quality of life (QoL) in patients undergoing coronary artery bypass grafting (CABG). METHODS: This randomized controlled trial (RCT) enrolled 120 patients undergoing CABG. Patients were allocated using computer-generated random numbers (1:1) to either the intervention group (n = 60), receiving a CCN plan, or the control group (n = 60), receiving standard postoperative care. The CCN intervention provided a patient-centered approach encompassing preoperative education, psychological support, continuous postoperative monitoring, personalized care plans, rehabilitation guidance, and structured follow-up extending for three months beyond discharge. RESULTS: Although baseline differences in BMI and Hb were noted, both groups were otherwise comparable. While Hb levels initially declined in both groups, by day 7 post-surgery, the CCN group demonstrated significantly higher Hb levels compared to the control group (12.28 ± 0.47 g/L vs. 9.16 ± 0.41 g/L; P < 0.001). The intervention group also showed significantly improved red blood cell morphology (lower MCV, P < 0.001; lower RDW, P < 0.001; higher HCT, P < 0.001), changes in IL-2 and IL-6 levels suggesting an immune response difference (higher IL-2, P < 0.001; lower IL-6, P < 0.001), superior QoL scores across all WHOQOL domains (psychological, social, environmental, physical; all P < 0.001), reduced depressive (CES-D, P < 0.001) and anxiety symptoms (SAS, P < 0.001), and significantly higher patient satisfaction (P < 0.001). CONCLUSION: Implementing a continuous comprehensive nursing system after CABG significantly benefits postoperative recovery, leading to improved hemoglobin levels, favorable red blood cell indices, measurable changes in immune markers, enhanced quality of life, improved mental health outcomes, and greater patient satisfaction compared to routine care. These findings suggest CCN is a promising strategy to optimize post-CABG patient outcomes.