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Preoperative Predictors of Hospital Readmission within 5 Years Following CABG: Cohort Analysis of the REPLICCAR II
Carlos Alberto Sancio Junior1, Fabiane Letícia de Freitas2, Gabrielle Barbosa Borgomoni2
1Hospital Santa Rita de Cássia, Vitoria, ES - Brasil.
Insights
Reducing hospital readmissions after coronary artery bypass grafting (CABG) is crucial. Key predictors for readmission include lower BMI, diabetes, renal failure, prior myocardial infarction, and higher STS scores.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
Background:
- Hospital readmissions after coronary artery bypass grafting (CABG) negatively impact patient outcomes.
- Optimizing post-CABG care necessitates understanding readmission drivers.
Purpose of the Study:
- To identify preoperative predictors of all-cause and cardiac readmissions within five years post-CABG.
- To inform strategies for reducing post-surgical readmission rates.
Main Methods:
- Analysis of 1,387 patients undergoing CABG from the REPLICCAR II registry (June 2017-July 2019).
- Follow-up via telephone interviews using a structured REDCap questionnaire.
- Statistical analysis included Cox regression with internal validation.
Main Results:
- Cumulative incidence of all-cause readmission was 27.69% over a mean 4.3-year follow-up.
- Significant predictors for readmission: lower body mass index, history of myocardial infarction, diabetes mellitus, renal failure, and higher STS score.
- Moderate correlation observed between readmission and mortality (Rho=0.55).
Conclusions:
- Preoperative factors like lower BMI, diabetes, renal failure, prior myocardial infarction, and elevated STS scores predict higher readmission risk after CABG.
- Identifying these predictors can guide targeted interventions to minimize post-CABG readmissions.
Background:
Reducing hospital readmissions following coronary artery bypass grafting (CABG) surgeries is essential to optimizing medium- and long-term patient outcomes.
Objective:
To analyze preoperative predictors associated with all-cause and cardiac readmissions within 5 years following CABG.
Methods:
We analyzed 1,387 patients who underwent CABG between June 2017 and July 2019 using data from the multicenter REPLICCAR II registry. Follow-up was carried out by telephone interviews using a questionnaire structured in the REDCap platform. Statistical analysis included univariate and multivariate methods, with Cox regression and internal validation through calibration and discrimination tests. A significance level of 5% was applied.
Results:
The cumulative incidence of all-cause readmission was 27.69%, with a mean follow-up of 4.3 years and a mean time to readmission of 2.4 years. Multivariate regression analysis indicated the following predictors of higher all-cause readmission risk: lower body mass index (HR=0.97, p=0.032), history of myocardial infarction (HR=1.27, p=0.024), diabetes mellitus (HR=1.35, p=0.004), renal failure (HR=1.62, p=0.004), and higher STS score (HR=1.22, p<0.001). A moderate correlation was observed between readmission and mortality (Rho=0.55).
Conclusions:
This analysis demonstrates that lower body mass index, history of myocardial infarction, diabetes mellitus, renal failure, and elevated STS scores are significant predictors of increased hospital readmission risk following CABG.
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