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Readmission of patients after coronary artery bypass graft surgery
1Yale New Haven Hospital and Yale University School of Nursing, Conn. 06536-0740, USA.
Insights
Hospital readmission after coronary artery bypass grafting (CABG) occurred in 14.5% of patients. Female sex and obesity were predictors of readmission, suggesting targeted follow-up may reduce rates.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
- Patient Outcomes
Background:
- Hospital readmission after coronary artery bypass grafting (CABG) presents a significant challenge in cardiovascular surgery.
- Understanding the rates, reasons, and predictors of readmission is crucial for improving post-operative care and patient outcomes.
Purpose of the Study:
- To determine the incidence, primary causes, and predictive factors associated with unplanned hospital readmissions following coronary artery bypass grafting (CABG).
Main Methods:
- A prospective, descriptive, correlational study involving 124 patients who underwent CABG.
- Data were collected via a mailed questionnaire administered 6 weeks post-discharge.
- Statistical analysis included logistic regression to identify predictors of readmission.
Main Results:
- 14.5% of patients experienced unplanned cardiac-related readmissions, with 44% of these occurring at community hospitals.
- The most common reasons for readmission were chest pain (with or without shortness of breath), incisional problems, and adverse reactions to analgesics.
- Female sex (OR 4.7) and obesity (OR 3.7) were identified as significant predictors of hospital readmission.
Conclusions:
- Targeted follow-up strategies focusing on high-risk groups, specifically women and obese patients, may be effective in reducing hospital readmission rates after CABG.
- These findings underscore the importance of tailored post-discharge care plans to mitigate readmission risks in cardiovascular surgery patients.
Objective:
To assess rates, reasons, and predictors of hospital readmission after coronary artery bypass grafting (CABG).
Methods:
In this prospective, descriptive, correlational study, 124 subjects responded to a mailed questionnaire 6 weeks after undergoing CABG at Yale New Haven Hospital.
Results:
The sample was 79% male, 94% white, and had a mean age of 66 +/- 10 years and a mean length of stay of 5.7 +/- 1.8 days. A total of 14.5% had unplanned cardiac-related readmissions (44% to their community hospital). Chest pain with or without shortness of breath was the primary reason for readmission (33%), followed by incisional problems (17%) and analgesic reactions (17%). Logistic regression analysis, based on bivariate analyses, revealed that female sex (odds ratio 4.7; 95% confidence interval, 1. 5-14.6; P =.007) and obesity (odds ratio 3.7; 95% confidence interval, 1.2-11.6; P =.026) predicted hospital readmission.
Conclusions:
Effective follow-up, with particular focus on women and the obese, may decrease readmissions. (Heart Lung((R)) 1999;28:243-50).