Preoperative White Blood Cell Count and Risk of 30-Day Readmission after Cardiac Surgery
| Autor: | David J. Malenka, Patrick Magnus, Dennis Duquette, Kelly LeBlond, Helen Desaulniers, Jeremiah R. Brown, Cathy S. Ross, Kristine Chaisson, Lawrence J. Dacey, Robert E. Helm, Susan R. Horton, Reed D. Quinn, Anthony W. DiScipio, R. Clive Landis, Richard A Boss, Cheryl Jones, Patricia Hofmaster, Benjamin M. Westbrook |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Article Subject Pulmonary disease Disease 030204 cardiovascular system & hematology Logistic regression 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine White blood cell lcsh:Pathology Immunology and Allergy Medicine 030212 general & internal medicine business.industry Odds ratio After discharge medicine.disease 3. Good health Cardiac surgery Surgery medicine.anatomical_structure business lcsh:RB1-214 Research Article |
| Zdroj: | International Journal of Inflammation International Journal of Inflammation, Vol 2013 (2013) |
| ISSN: | 2090-8040 |
| DOI: | 10.1155/2013/781024 |
| Popis: | 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 >12,000 mm3) had higher 30-day readmission than those with lower levels of WBC 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|