Early Readmission of Low-Risk Patients after Coronary Surgery
| Autor: | Paul J. Corso, Ammar S. Bafi, Xiumei Sun, Kathleen R. Petro, Peter C. Hill, Jorge M. Garcia, Li Zhang, Steven W. Boyce, Elizabeth Haile, Robert C. Lowery |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Patient Readmission Risk Assessment law.invention Cohort Studies Postoperative Complications Risk Factors law Diabetes mellitus Internal medicine medicine Humans Coronary Artery Bypass Early discharge Retrospective Studies Framingham Risk Score business.industry Incidence Odds ratio Perioperative Middle Aged medicine.disease Intensive care unit Confidence interval Surgery District of Columbia Cohort Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Heart Surgery Forum. 11:E327-E332 |
| ISSN: | 1522-6662 1098-3511 |
| DOI: | 10.1532/hsf98.20071192 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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