Patient selection: CABG
Outcome: 30-day hospital readmission
The leading cause for readmission was infection (surgical site, sepsis, pneumonia, other), which represented a quarter of the cases.
Risk factors independently associated with 30-day readmission:
(1) age > 70 years
(2) female gender
(3) race Afro-American
(4) body mass index (BMI) >= 35 kg per square meter)
(5) comorbidities (see below)
(6) post-operative renal failure
(7) unplanned cardiac reoperation
(8) primary payer Medicare or Medicaid
(9) discharge to a skilled nursing facility
(10) saphenous vein graft only (no use of internal mammary artery)
(11) longer length of stay (>= 5 days)
Comorbidities:
(1) cerebrovascular disease
(2) periphral vascular disease
(3) congestive heart failure
(4) chronic obstructive pulmonary disease (COPD)
(5) extensive aortic atherosclerosis
(6) diabetes mellitus
(7) 3-vessel coronary artery disease
(8) immunodeficiency
(9) left ventricular ejection fraction < 30%
(10) serum creatinine > 2.5 mg/dL
(11) dialysis
Of these risk factors the only ones with adjusted odds ratios > 1.5:
(1) body mass index >= 40 kg per square meter (OR 1.6)
(2) unplanned cardiac reoperation (OR 1.6)
(3) length of stay >= 7 days (OR 1.7 to 2.1)
Because of the relatively low odds ratios, multiple risk factors must be present before the cumulative odds become significant.
