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Does anemia impact hospital readmissions after coronary artery bypass surgery?
Nadine Shehata1, Alan Forster, Le Li
1Department of Medicine, Institute of Health Policy Management and Evaluation, Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada. nshehata@mtsinai.on.ca
Insights
Anemia after coronary artery bypass graft (CABG) surgery did not predict 30-day hospital readmissions. Other factors like comorbidities and infections were more significant predictors of readmission following CABG.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Critical Care Medicine
Background:
- Anemia is a common complication following coronary artery bypass graft (CABG) surgery, linked to increased morbidity and mortality.
- The association between anemia and hospital readmission after CABG has not been previously investigated.
Purpose of the Study:
- To determine if anemia at hospital discharge is associated with increased 30-day hospital readmissions after CABG.
- To investigate the relationship between anemia and readmission for cardiac disease or 30-day mortality post-CABG.
Main Methods:
- A retrospective study of 2102 patients undergoing CABG in Ontario was conducted.
- Administrative data were used to assess 30-day hospital readmissions, cardiac readmissions, and 30-day mortality.
- Predischarge hemoglobin (Hb) levels were analyzed in relation to readmission and mortality outcomes.
Main Results:
- Of 2102 patients, 11% were readmitted within 30 days; infection was the leading cause (24%).
- Predischarge hemoglobin concentration was not a significant independent predictor of 30-day readmission (all causes or cardiac) or 30-day mortality.
- Higher comorbidity scores, wound infections, and postoperative renal failure were associated with increased 30-day readmission rates.
Conclusions:
- Predischarge hemoglobin levels after CABG surgery were not associated with 30-day hospital readmissions.
- Factors such as comorbidities and post-operative complications are more strongly associated with readmission risk after CABG.
Background:
Anemia is one of the most common complications of coronary artery bypass graft (CABG) surgery and has been shown to be associated with increased morbidity and mortality. The impact of anemia on hospital readmission after CABG, a potential measure of delayed complications, has not been addressed.
Study Design And Methods:
We conducted a single-center retrospective study of 2102 patients who had CABG in Ontario to determine whether anemia at hospital discharge was associated with increased 30-day hospital readmissions, readmission secondary to cardiac disease, and 30-day mortality using administrative data.
Results:
Of the 2102 patients, 224 patients (11%) were readmitted within 30 days of hospital discharge. Infection was the leading cause of readmissions (24%), followed by heart failure (13%), pulmonary disease (7%), and hemorrhagic disease (7%). Overall, 2.6% of patients were readmitted because of cardiac disease. Of patients discharged, 48% were discharged with a hemoglobin (Hb) level between 8 and 10 g/dL and 42% between 10 and 12 g/dL. Predischarge Hb concentration was not a significant independent predictor of 30-day readmission to the hospital due to all causes, readmission to the hospital due to cardiac causes, or 30-day mortality. A higher comorbidity score, adjusted odds ratio (OR) of 2.1 (95% confidence interval [CI], 1.3-3.6), leg and sternal wound infections OR of 1.9 (95% CI, 1.2-3.0), and postoperative renal failure OR of 1.4 (95% CI, 1.2-2.0) were associated with increased 30-day readmission rates.
Conclusions:
The predischarge Hb concentration after CABG was not associated with 30-day readmissions.
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