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Published on: July 18, 2014
Unplanned hospital readmissions following congenital heart diseases surgery. Prevalence and predictors
1Pediatric Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail. aazhar@kau.edu.sa.
Insights
Unplanned hospital readmissions after congenital heart defect (CHD) surgery occur at a rate of 15.9%. Key risk factors include preoperative mechanical ventilation and prolonged postoperative length of stay.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Healthcare Outcomes Research
Background:
- Congenital heart defects (CHD) are common birth abnormalities requiring surgical intervention.
- Unplanned hospital readmissions post-CHD repair can indicate suboptimal care and increase healthcare costs.
Purpose of the Study:
- To determine the incidence of unplanned hospital readmissions following surgical repair of CHD.
- To identify associated causes and risk factors for these readmissions.
Main Methods:
- Retrospective chart review of 189 patients undergoing CHD surgical repair at King Abdulaziz University Hospital.
- Analysis of demographic, perioperative, and readmission data within 12 months post-surgery, excluding planned admissions.
Main Results:
- The unplanned readmission rate was 15.9% within one year.
- Significant associations found with preoperative mechanical ventilation, intraoperative complications, and prolonged postoperative length of stay.
- Independent risk factors for readmission included preoperative mechanical ventilation and postoperative length of stay exceeding 10 days.
Conclusions:
- Readmission rates for CHD surgery are comparable to existing literature.
- Further research is needed to address modifiable risk factors like postoperative complications to reduce readmissions.
Objectives:
To estimate the rate of unplanned hospital readmission following surgical repair of congenital heart defects (CHD) and investigate the related causes and risk factors.
Methods:
A retrospective chart review of all the patients who underwent surgical repair of CHD at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. The study outcome consisted of any hospital admission during the 12 months following the first reparative surgery. Exclusion criteria included planned admissions. Patients' demographic and readmission data as well as the perioperative data were collected and analyzed as factors and predictors of unplanaed readmission.
Results:
After the exclusion of the deceased patients, a total of 189 patients were included. The readmission rate was 15.9% during a one-year period following surgery. There was a significant association between the probability of readmission and preoperative mechanical ventilation (MV) (p less than 0.001), intraoperative complications (p=0.025), prolonged postoperative length of stay (LOS) (p less than 0.001), early postoperative complication (p=0.007), long postoperative MV stay, and drain tube stay (p=0.011). Significant predictors of unplanned readmission included young age (1-12 months) and low weight at surgery (less than 5kg), preoperative MV, intraoperative complications, postoperative LOS ≥10 days, pediatric intensive care unit stay, MV stay, drain tube stay, infections, respiratory complication, and feeding problems. Only the preoperative MV and LOS greater than 10 days were the independent risk factors.
Conclusion:
Readmission rates were similar to those reported in other studies. Future studies are warranted to investigate suitable actions to alleviate the modifiable risk factors, such as postoperative complications.
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