Early Readmission of Low-Risk Patients after Coronary Surgery

Authors

  • Xiumei Sun
  • Li Zhang
  • Robert Lowery
  • Kathleen R. Petro
  • Peter C. Hill
  • Elizabeth Haile
  • Jorge M. Garcia
  • Ammar S. Bafi
  • Steven W. Boyce
  • Paul J. Corso

DOI:

https://doi.org/10.1532/HSF98.20071192

Abstract

Background: Early readmission after coronary artery bypass grafting (CABG) is an expensive adverse outcome. Although the perioperative experience of high-risk CABG patients has been studied extensively, little attention has been paid to low-risk CABG patients. The primary goal of this study was to identify the preoperative characteristics and to define risk predictors of readmission and preventive factors for readmission in low-risk isolated-CABG patients.

Methods: We identified 2157 patients who underwent CABG between January 2000 and December 2005 at Washington Hospital Center, Washington, DC, and defined as low risk patients who had a Parsonnet bedside risk score lower than the 25th percentile. Patients who were rehospitalized within 30 days after surgery were compared with those who were not rehospitalized during this period.

Results: The overall readmission rate for this study cohort was 6.3%. Compared with non-readmitted patients, early-readmitted patients were more likely to have diabetes mellitus (27.94% versus 20.88%, P = .05) and less likely to have hypertension (42.65% versus 51.36%, P = .05). Blood product transfusion (P < .01), postoperative length of intensive care unit stay (P = .01), and length of hospital stay (P = .05) were all significantly increased in the readmitted patients. The use of ?-blockers (P = .03) and angiotensin-converting enzyme inhibitors (P = .04) was significantly lower at discharge in this group of patients; however, multivariate regression analysis demonstrated diabetes (odds ratio, 1.59; 95% confidence interval, 1.08-2.42) to be the only independent predictor of early readmission.

Conclusions: For low-risk CABG patients, diabetes mellitus is the risk predictor of early readmission. Early discharge was not associated with early readmission.

References

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Published

2008-12-15

How to Cite

Sun, X., Zhang, L., Lowery, R., Petro, K. R., Hill, P. C., Haile, E., Garcia, J. M., Bafi, A. S., Boyce, S. W., & Corso, P. J. (2008). Early Readmission of Low-Risk Patients after Coronary Surgery. The Heart Surgery Forum, 11(6), E327-E332. https://doi.org/10.1532/HSF98.20071192

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