Exploring the risk of early dismissal following cardiac operations

The expense for routine postoperative surveillance contributes importantly to the cost of cardiac operations. This study was established to determine the feasibility of earlier dismissals following surgery and whether this would be accompanied by increased risk. All 80 adult cardiac surgery patients undergoing a cardiac operation at one institution during the final quarter of 1983 were included in this prospective study. Patient ages ranged from 34 to 81 years with a mean of 63. Fifty-two per cent were over 65 years old. There were 57 men and 23 women. Of the 80 cardiac operations 85% were coronary artery bypass procedures, with 15% valve operations or other. There was one hospital death. The mean length of postoperative hospitalization was 5 days, and 73% of the patients left the hospital by the 5th postoperative day. Follow-up for 60 days revealed no readmissions nor complications in patients dismissed in 5 days or less. There was one late death presumably from a ventricular arrhythmia in a patient dismissed on the 7th postoperative day. Three point eight per cent (3/79) of the discharged patients were readmitted for varying reasons. The majority of adult cardiac surgery patients can be dismissed safely by the 5th postoperative day. Patients having ventricular arrhythmias or lacking adequate home care are not candidates for early dismissal.