Abstract
ObjectiveTo evaluate the frequency, causes, and related predictive factors of intensive care unit (ICU) readmissions after coronary artery bypass grafting (CABG) surgery.MethodsA total of 4112 consecutive patients who underwent on-pump CABG between January 2007 and January 2017 were retrospectively evaluated. The patients were divided into two groups as patients with and without ICU readmission. Demographic and perioperative characteristics were compared between the two groups.ResultsThe ICU readmission rate was 3.5%. The most common reasons for ICU readmissions were respiratory (29%) and cardiac (23.4%) complications. The 90-day mortality risk was significantly higher in the readmitted patients than the non-readmitted patients (22.1% and 1.6%, respectively; P<0.001; OR=17.6; 95% CI=11.19-28.41). Severe left ventricular dysfunction, chronic obstructive pulmonary disease, end-stage renal disease, emergency CABG, EuroSCORE II > 5%, cross-clamp time > 35 minutes, postoperative respiratory complications, neurological complications, and cardiac complications showed a strong association with ICU readmissions.ConclusionICU readmission after CABG is associated with an increased mortality rate. Evaluation, not only of patients’ comorbidities, but also of intraoperative conditions and postoperative complications, is important to identify patients at risk for ICU readmission.
Highlights
intensive care unit (ICU) readmission after coronary artery bypass grafting (CABG) is associated with an increased mortality rate
Major complications associated with coronary artery bypass grafting (CABG) surgery and overall risk factors associated with mortality are well defined
We investigated the preoperative, intraoperative and early postoperative predictive factors of ICU admissions
Summary
Major complications associated with coronary artery bypass grafting (CABG) surgery and overall risk factors associated with mortality are well defined. There are widely used risk models for early mortality after cardiac surgery[1,2]. Despite advances in surgical techniques and postoperative management strategies, postoperative complications occur in 13 to 38% of patients[3,4]. After the first discharge from the intensive care unit (ICU), a number of patients require ICU follow-up again[5]. Potential reasons for ICU readmissions are intraoperative deficiencies, clinical conditions lost in the early postoperative period, premature discharge from ICU in initial hospitalization, aggravation of patients’ comorbidities or defined treatmentrelated complications. ICU applications both extend the length of
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