Predictors of readmission for complications of coronary artery bypass graft surgery

Area of Science:

• Cardiovascular Surgery
• Health Services Research

Background:

• Perioperative mortality after coronary artery bypass graft (CABG) surgery is well-studied.
• Factors influencing early readmissions post-CABG remain less clear.

Purpose of the Study:

• To identify significant predictors of 30-day readmission following CABG surgery.
• To understand the causes and associated risk factors for early CABG readmissions.

Main Methods:

• A retrospective analysis of 16,325 patients undergoing CABG in New York from 1999-2000.
• Investigated patient demographics, preoperative risk factors, complications, operative/postoperative factors, and provider characteristics.
• Examined causes for readmission within 30 days of discharge.

Main Results:

• 12.9% of patients were readmitted within 30 days post-CABG.
• Most common readmission causes were postsurgical infection (28%) and heart failure (16%).
• Eleven risk factors, including older age, female sex, African American race, greater body surface area, recent myocardial infarction, and six comorbidities, were associated with higher readmission rates. Provider characteristics (low surgeon volume, high hospital mortality rate) and postoperative factors (discharge to facility, prolonged length of stay) also predicted readmission.

Conclusions:

• Thirty-day readmission is a significant adverse outcome after CABG.
• Readmission rates can potentially supplement mortality data in assessing provider quality.