Abstract
Abstract: Background: Readmissions are a common problem in cardiac surgery. As cardiac operations being common major elective operations in older adults representing an increasing portion of surgical candidates. Data regarding prevalence of readmission and risk factors in such population is needed. Aim: To assess the frequency and risk factors associated with hospital 30 days readmissions for elderly patients undergoing cardiac operations. Methods: A prospective observational cohort study was conducted from the first of March, 2017 to the end of March, 2018, where 180 patients aged ≥60 years undergoing elective cardiac operations in Ain Shams University hospital were included. Participants were subjected to full history taking and physical examination. Type of operation and thirty days readmission following surgery were documented. Results: 30 days readmission rate was 20.2% (number of readmissions, 36). When stratified by procedure type, readmission rates were isolated coronary artery bypass grafting (CABG), 66.7% (n=24); isolate valve, 8.3% (n=3); CABG + valve, 25% (n=9). Baseline patient characteristics associated with readmission included male gender, elevated creatinine, dementia, congestive heart failure and presence of multiple comorbidities”≥3”. Conclusions: 1 of 5 elderly patients undergoing cardiac operations requires readmission within 30 days after surgery. This outcome has significant health and economic implications. Further studies are needed to assess causes of readmission and to determine which readmission strategies are most effective for elderly patients undergoing cardiac surgeries.
Highlights
Hospital readmission rates following surgery are increasingly used as a marker of quality of care
Advancements have been made during the past decade in improving outcomes after cardiac operations, readmission rates remain high ranging from 8.3% to 21.1% in patients undergoing coronary artery bypass grafting (CABG) operations 4
In the current prospective cohort of elderly cardiac surgical patients, the thirty days readmission rate was 20.2%. a 30-days time point for examining readmissions has often been criticized as clinically arbitrary, a large, multicenter, prospective cohort of 5059 adult cardiac surgical patients demonstrated that the 30-days period captures most of the readmissions 5
Summary
Hospital readmission rates following surgery are increasingly used as a marker of quality of care. Studies on readmission rates in surgical patients are limited by the restricted number of procedures they examine, the exclusive age categories that are included, and the lack of distinction of elderly patients from other surgical patients 1. It has been shown that outcomes in surgical patients, including readmission rates, vary significantly by patient age, procedure type, and surgical specialty 2. Older adults are an increasing proportion of surgical
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