[MSB-05] Early Discharge After Isolated Coronary Artery Bypass Graft Surgery Does Not Increase Risk of
Ahmet Can Topçu1,2, Fatih Yiğit1,2, Fatma İrem Öztürk1
1Department of Cardiovascular Surgery, Koşuyolu High Specialization Education and Research Hospital, İstanbul, Türkiye.
Insights
Early discharge after coronary artery bypass grafting (CABG) is safe, showing no increased risk of hospital readmission or emergency room (ER) visits within 30 days. This finding supports current discharge practices for CABG patients.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
Background:
- Early discharge protocols are increasingly explored in various surgical fields.
- Optimizing hospital resource utilization and patient flow is a key healthcare objective.
Purpose of the Study:
- To determine if early discharge (≤5 days) after isolated coronary artery bypass grafting (CABG) surgery increases 30-day hospital readmission or emergency room (ER) presentation rates.
- To identify predictors of hospital readmission following CABG.
Main Methods:
- A retrospective cohort study analyzed data from 608 adult patients undergoing isolated CABG between May and December 2023.
- Patients were categorized into early discharge (≤5 days) and late discharge (>5 days) groups.
- Primary outcome was 30-day all-cause hospital readmission; secondary outcome was 30-day ER presentation.
Main Results:
- Early discharge (n=228) and late discharge (n=380) groups showed similar 30-day readmission rates (7.0% vs. 10.0%, p=0.211) and ER presentation rates (25.4% vs. 29.5%, p=0.283).
- Multivariate analysis identified prolonged mechanical ventilation, sternal wound infection, stroke, and atrial fibrillation as significant predictors of readmission.
Conclusions:
- Early discharge after isolated CABG is not associated with a higher risk of 30-day hospital readmission or ER visits.
- Predictors of readmission include postoperative complications such as ventilation duration, infections, stroke, and arrhythmias.
Objective:
This study aimed to investigate whether early discharge after coronary artery bypass grafting (CABG) is associated with increased rates of hospital readmission and emergency room (ER) presentation.
Methods:
This retrospective cohort study utilized data from the Koşuyolu Adult Cardiac Surgery Quality Improvement Program database. Consecutive adults who underwent isolated CABG at a single institution between May 2023 and December 2023 were assessed for eligibility. Patients were excluded if they had surgery other than isolated CABG, experienced in-hospital mortality, or had a prolonged length of stay (>14 days) during index hospitalization. The study population was divided into early discharge (≤5 days) and late discharge (>5 days) groups. The primary endpoint was all-cause hospital readmission within 30 days of discharge, while the secondary endpoint was ER presentation for any reason within 30 days of discharge.
Results:
The final cohort included 608 patients (228 early-discharge, 380 late-discharge). Median age was 61 years (interquartile range, 54-67). Groups were balanced in terms of demographics, risk profile, operative details, and outcomes. Thirty-day rehospitalization and ER presentation rates were lower in the early discharge group compared to the late discharge group; however, the differences were statistically insignificant (7.0% vs. 10.0%, p=0.211; 25.4% vs. 29.5%, p=0.283; respectively). Multivariate logistic regression analysis identified postoperative mechanical ventilation duration, sternal wound infection, postoperative stroke, and discharge with atrial fibrillation as the strongest predictors of hospital readmission within 30 days of discharge (odds ratio [OR]=1.049, 95% confidence interval [CI] 1.000-1.100; OR=10.268, 95% CI 1.882-56.032; OR=39.891, 95% CI 1.980-803.624; OR=24.724, 95% CI 1.499-407.804; respectively).
Conclusion:
Early discharge after isolated CABG surgery was not associated with increased rates of hospital readmission or ER presentation within 30 days of discharge.
