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Predictors of hospital readmission two years after coronary artery bypass grafting
J Herlitz1, P Albertsson, G Brandrup-Wognsen
1Division of Cardiology, Sahlgrenaka University Hospital, Göteborg, Sweden.
Insights
Nearly half of patients require hospital readmission within two years of coronary artery bypass grafting (CABG). Key predictors include patient history, operation status, postoperative complications, and early post-operative findings and medication.
Area of Science:
- Cardiology
- Clinical Medicine
- Surgical Outcomes
Background:
- Coronary artery bypass grafting (CABG) is a common surgical procedure for coronary heart disease.
- Understanding readmission risks post-CABG is crucial for improving patient outcomes and healthcare resource allocation.
Purpose of the Study:
- To identify clinical factors associated with hospital readmission within two years following coronary artery bypass grafting (CABG).
Main Methods:
- A retrospective study of patients undergoing CABG without valve surgery in western Sweden between 1988 and 1991.
- Readmission data was collected via postal inquiry and hospital records for all discharged patients.
Main Results:
- 44% of 2033 eligible patients were readmitted within two years post-CABG.
- Common reasons for readmission included angina pectoris and congestive heart failure.
- Twelve independent predictors for readmission were identified, encompassing clinical history, acute operation, postoperative complications, and early post-operative clinical findings and medication.
Conclusions:
- A significant proportion of patients experience hospital readmission after CABG, primarily due to cardiac events.
- Predictive clinical markers identified can aid in risk stratification and targeted interventions for post-CABG patients.
Objective:
To determine the clinical factors before, and in association with, coronary artery bypass grafting (CABG) that increase the risk of readmission to hospital in the first two years after surgery.
Patients:
All patients in western Sweden who had CABG without simultaneous valve surgery between 1 June 1988 and 1 June 1991.
Methods:
All patients who were readmitted to hospital were evaluated by postal inquiry and hospital records.
Results:
A total of 2121 patients were operated on, of whom 2037 were discharged from hospital. Information regarding readmission was missing in four patients, leaving 2033 patients; 44% were readmitted to hospital. The most common reasons for readmission were angina pectoris and congestive heart failure. There were 12 independent significant predictors for readmission: clinical history (a previous history of either congestive heart failure or myocardial infarction, or CABG); acute operation; postoperative complications (time in intensive care unit greater than two days, neurological complications); clinical findings four to seven days after the operation (arrhythmia, systolic murmur equivalent to mitral regurgitation); medication four to seven days after the operation (antidiabetics, diuretics for heart failure, other antiarrhythmics (other than beta blockers, calcium antagonists, and digitalis), and lack of treatment with aspirin).
Conclusion:
44% of patients were readmitted to hospital two years after CABG. The most common reasons for readmission were angina pectoris and congestive heart failure. Four clinical markers predicted readmission: clinical history; acute operation status; postoperative complications; and clinical findings and medication four to seven days after operation.