Researcher Finds Coronary Bypass Patients Return to Hospital
Within 30 Days of Discharge
Published in JAMA, August 13
Advisory: To receive a copy of the paper or to contact Edward
L. Hannan, Ph.D., call Lisa James Goldsberry at (518) 437-4980.
N.Y. (August 13, 2003)- - About 13 percent of patients discharged
from a hospital following coronary artery bypass graft (CABG)
surgery are readmitted within 30 days for reasons related
to the surgery, according to a study in the August 13 issue
of The Journal of the American Medical Association (JAMA).
Edward Hannan of the University at Albany's School of Public
Health was lead author of the study.
to background information in the article, CABG surgery may
be the most frequently studied of all surgical procedures,
probably in part because of its expense, the frequency with
which it is performed, and that it relates to the most common
cause of death in the United States, coronary heart disease.
Risk factors for death after CABG surgery have been studied
extensively, however which factors are associated with early
readmissions are less clear.
Ph.D., and colleagues examined the frequency and causes of
hospital readmissions within 30 days following CABG surgery
in the state of New York from January 1, 1999, through December
found that of 16,325 total patients, 2,111 (12.9 percent)
were readmitted within 30 days for reasons related to CABG
surgery. The most common causes of readmission were postsurgical
infection (n=598 [28 percent]) and heart failure (n=331 [16
percent]). Eleven risk factors were independently associated
with higher readmission rates: older age, female sex, African
American race, greater body surface area, previous myocardial
infarction within 1 week, femoral/popliteal (artery) disease,
congestive heart failure, chronic obstructive pulmonary disease,
diabetes, hepatic failure, and renal failure.
controlling for these preoperative patient-level risk factors,
two physician characteristics (annual CABG volume less than
100 or hospital risk-adjusted death rate in the highest decile)
and 2 postoperative factors (discharge to nursing home or
rehabilitation/acute care facility or length of stay during
index CABG admission of 5 days or greater) were also related
to higher readmission rates.
to hospital shortly after CABG is a common problem. Although
we identified a number of important predictors for readmission,
much variability in readmission rates remains unexplained.
Future research will be needed to better understand why many
patients require readmission after undergoing CABG surgery,"
the authors conclude.
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