Affiliation:
1. Hospital João XXIII, Brasil
2. Universidade de São Paulo, Brasil
3. Instituto Dante Pazzanese de Cardiologia, Brasil
Abstract
Abstract Background: The analysis of indicators such as hospital readmission rates is crucial for improving the quality of services and management of hospital processes. Objectives: To identify the variables correlated with hospital readmission up to 30 days following coronary artery bypass grafting (CABG). Methods: Cross-sectional cohort study by REPLICCAR II database (N=3,392) from June 2017 to June 2019. Retrospectively, 150 patients were analyzed to identify factors associated with hospital readmission within 30 days post-CABG using univariate and multivariate logistic regression. Analysis was conducted using software R, with a significance level of 0.05 and 95% confidence intervals. Results: Out of 3,392 patients, 150 (4,42%0 were readmitted within 30 days post-discharge from CABG primarily due to infections (mediastinitis, surgical wounds, and sepsis) accounting for 52 cases (34.66%). Other causes included surgical complications (14/150, 9.33%) and pneumonia (13/150, 8.66%). The multivariate regression model identified an intercept (OR: 1.098, p<0.00001), sleep apnea (OR: 1.117, p=0.0165), cardiac arrhythmia (OR: 1.040, p=0.0712), and intra-aortic balloon pump use (OR: 1.068, p=0.0021) as predictors of the outcome, with an AUC of 0.70. Conclusion: 4.42% of patients were readmitted post-CABG, mainly due to infections. Factors such as sleep apnea (OR: 1.117, p=0.0165), cardiac arrhythmia (OR: 1.040, p=0.0712), and intra-aortic balloon pump use (OR: 1.068, p=0.0021) were predictors of readmission, with moderate risk discrimination (AUC: 0.70).
Publisher
Sociedade Brasileira de Cardiologia
Reference23 articles.
1. Continuous Quality Improvement Programme in Cardiovascular Surgery: The Latin American Perspective;Mejía OA;Eur J Cardiothorac Surg,2016
2. Analysis of >100,000 Cardiovascular Surgeries Performed at the Heart Institute and a New Era of Outcomes;Mejia OAV;Arq Bras Cardiol,2020
3. Quality Measurement in Healthcare;Lazar EJ;Annu Rev Med,2013
4. É Preciso Evitar Ida a Hospitais, Diz Médica sobre Riscos da Pandemia [Internet];Richtmann R
5. Thirty-day Hospital Readmissions Following Cardiac Surgery are Associated with Mortality and Subsequent Readmission;Bianco V;Semin Thorac Cardiovasc Surg,2021