Preoperative White Blood Cell Count and Risk of 30-Day Readmission after Cardiac Surgery.
| Autor: | Brown, Jeremiah R., Clive Landis, R., Chaisson, Kristine, Ross, Cathy S., Dacey, Lawrence J., Boss Jr., Richard A., Helm, Robert E., Horton, Susan R., Hofmaster, Patricia, Jones, Cheryl, Desaulniers, Helen, Westbrook, Benjamin M., Duquette, Dennis, LeBlond, Kelly, Quinn, Reed D., Magnus, Patrick C., Malenka, David J., DiScipio, Anthony W. |
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| Předmět: |
ACADEMIC medical centers
CHI-squared test CONFIDENCE intervals EPIDEMIOLOGY CARDIAC surgery MEDICAL records MULTIVARIATE analysis PREOPERATIVE care RESEARCH funding STATISTICS T-test (Statistics) LOGISTIC regression analysis DATA analysis RETROSPECTIVE studies RECEIVER operating characteristic curves PATIENT readmissions DATA analysis software DESCRIPTIVE statistics LEUKOCYTE count |
| Zdroj: | International Journal of Inflammation; 2013, p1-7, 7p |
| Abstrakt: | Approximately 1 in 5 patients undergoing cardiac surgery are readmitted within 30 days of discharge. Among the primary causes of readmission are infection and disease states susceptible to the inflammatory cascade, such as diabetes, chronic obstructive pulmonary disease, and gastrointestinal complications. Currently, it is not known if a patient's baseline inflammatory state measured by crude white blood cell (WBC) counts could predict 30-day readmission. We collected data from 2,176 consecutive patients who underwent cardiac surgery at seven hospitals. Patient readmission data was abstracted from each hospital. The independent association with preoperative WBC count was determined using logistic regression. There were 259 patients readmitted within 30 days, with a median time of readmission of 9 days (IQR 4-16). Patients with elevated WBC count at baseline (10,000-12,000 and >12,000mm3) had higher 30-day readmission than those with lower levels ofWBC count prior to surgery (15% and 18% compared to 10%-12%, P = 0.037). Adjusted odds ratios were 1.42 (0.86, 2.34) for WBC counts 10,000-12,000 and 1.81 (1.03, 3.17) for WBC count > 12,000. We conclude that WBC count measured prior to cardiac surgery as a measure of the patient's inflammatory state could aid clinicians and continuity of care management teams in identifying patients at heightened risk of 30-day readmission after discharge from cardiac surgery. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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