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• W2912505365 abstract "Since its introduction, coronary artery bypass grafting (CABG) has been the revascularisation intervention of choice in patients with complex coronary artery disease.1, 2 CABG is the most common cardiac surgical procedure.3 Those reshospitalised within 30 days of discharge incur greater healthcare costs and have worse prognoses.4, 5 Although several studies have considered the subject, there is still inconsistent data regarding the causes of 30-day readmission after CABG. The majority of previous studies have reported data derived from the USA, the results of which may not be generalisable to other populations.4, 6-8 To evaluate the incidence, causes and predictors of 30-day readmission after CABG, we performed the first study of a contemporary cohort of patients in a large UK tertiary hospital. The cohort for this retrospective audit was obtained from prospectively entered data from inpatient admissions following CABG between April 2012 and March 2017 at the Royal Stoke University Hospital (RSUH). Patients having other combined procedures or outside the catchment area for RSUH were excluded. The National Adult Cardiac Surgery Audit database was used to identify potential participants and collect anonymised data on patient demographics, preoperative risk factors, postoperative care and in-hospital mortality.9 Patients’ electronic records were retrospectively reviewed to identify reasons for readmission and care received prior to readmission. The official online calculator was used to calculate the EUROScore II, which is a validated risk of mortality score.10 STATA 14 was used to perform data analysis of variance for continuous variables and χ2 test for categorical variables. Multiple logistic regression was performed to identify predictors of 30-day readmission. Predictors with P value <0.1 were included in a multivariate model using stepwise regression analysis to determine independent predictors of 30-day readmission. Between 2012 and 2017, 659 patients were admitted to the Royal Stoke University Hospital for CABG (Figure 1). The majority of admissions occurred within the first week after discharge (Figure 2). Patients who were readmitted within 30 days (P < 0.05) were more likely to be male, smokers, be diabetic or have renal disease or previous stroke (Table 1). Non-cardiac causes accounted for 80% of the readmissions (Table 2). The most common causes of readmission were sternal wound infection (11.8%) and lower respiratory tract infection or exacerbation of COPD (10.5%). Female sex, diabetes, previous stroke, peripheral vascular disease and renal disease were all univariate predictors of readmission (P < 0.05). Readmission was not associated the with urgency of operation, number of grafts used, New York Heart Association (NYHA) score or EUROScore II (Table 3). Risk of readmission was lower in male patients (aOR 0.43 95% CI 0.23-0.79). Positive predictors of readmission included renal disease (aOR 2.03 95% CI 1.21-3.43), previous stroke (aOR 2.81 95% CI 1.25-6.29) and diabetes (aOR 1.99 95% CI 1.17-3.38) (Table 4). The current analysis shows that readmission is common and most often because of non-cardiac causes such as sternal wound infections. Readmissions are more frequent in certain patient groups and characterisation of these factors will facilitate the prediction of risk of readmission. None." @default.
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• W2912505365 date "2019-04-01" @default.
• W2912505365 modified "2023-09-27" @default.
• W2912505365 title "Early readmissions after isolated coronary artery bypass grafting" @default.
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• W2912505365 doi "https://doi.org/10.1111/ijcp.13319" @default.
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