Predictors of Readmission for Complications of Coronary Artery Bypass Graft Surgery
2003; American Medical Association; Volume: 290; Issue: 6 Linguagem: Inglês
10.1001/jama.290.6.773
ISSN1538-3598
Autores Tópico(s)Heart Failure Treatment and Management
ResumoRisk factors for perioperative mortality after coronary artery bypass graft (CABG) surgery have been extensively studied. However, which factors are associated with early readmissions following CABG surgery are less clear.To identify significant predictors of readmission within 30 days following CABG surgery.Causes for readmission within 30 days were investigated for all patients discharged after CABG surgery in the state of New York from January 1, 1999, through December 31, 1999. A variety of patient demographics, preoperative risk factors, complications, operative and postoperative factors, and provider characteristics were considered as potential predictors of readmissions.Hospital readmissions within 30 days of discharge following CABG surgery.Of 16 325 total patients, 2111 (12.9%) were readmitted within 30 days for reasons related to CABG surgery. The most common causes of readmission were postsurgical infection (n = 598 [28%]) and heart failure (n = 331 [16%]). Eleven risk factors were found to be independently associated with higher readmission rates: older age, female sex, African American race, greater body surface area, previous myocardial infarction within 1 week, and 6 comorbidities. After controlling for these preoperative patient-level risk factors, 2 provider characteristics (annual surgeon CABG volume or =5 days) were also related to higher readmission rates.Readmission within 30 days following discharge is an important adverse outcome of CABG surgery. Continued attempts should be made to explore the potential of readmission as a supplement to mortality in assessing provider quality.
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