28 February 2013
A case-control study of readmission to the intensive care unit after cardiac surgery
Rimantas BenetisADG, Edmundas ŠirvinskasADE, Birute KumpaitieneBCDF, Šarunas KindurisADEFDOI: 10.12659/MSM.883814
Med Sci Monit 2013; 19:148-152
Abstract
BACKGROUND: The aim of this study was to identify predictors of repeated admission to the intensive care unit (ICU) of patients who underwent cardiac surgery procedures.
MATERIAL AND METHODS: This retrospective study analyzed 169 patients who underwent isolated coronary artery bypass grafting (CABG) between January 2009 and December 2010. The case group contained 54 patients who were readmitted to the ICU during the same hospitalization and the control group comprised 115 randomly selected patients.
RESULTS: Logistic regression analysis revealed that independent predictors for readmission to the ICU after CABG were: older age of patients (odds ratio [OR] 1.04; CI 1.004–1.08); body mass index (BMI) >30 kg/m2 (OR 2.55; CI 1.31–4.97); EuroSCORE II >3.9% (OR 3.56; CI 1.59–7.98); non-elective surgery (OR 2.85; CI 1.37–5.95); duration of operation >4 h (OR 3.44; CI 1.54–7.69); bypass time >103 min (OR 2.5; CI 1.37–4.57); mechanical ventilation >530 min (OR 3.98; CI 1.82–8.7); and postoperative central nervous system (CNS) disorders (OR 3.95; CI 1.44–10.85). The hospital mortality of patients who were readmitted to the ICU was significantly higher compared to the patients who did not require readmission (17% vs. 3.8%, p=0.025).
CONCLUSIONS: Identification of patients at risk of ICU readmission should focus on older patients, those who have higher BMI, who underwent non-elective surgery, whose operation time was more than 4 hours, and who have postoperative CNS disorders. Careful optimization of these high-risk patients and caution before discharging them from the ICU may help reduce the rate of ICU readmission, mortality, length of stay, and cost.
Keywords: Patient Readmission - statistics & numerical data, Logistic Models, Multivariate Analysis, Intensive Care Units - statistics & numerical data, Coronary Artery Bypass, Case-Control Studies, Cardiac Surgical Procedures - statistics & numerical data, Risk Factors, Time Factors
Editorial
01 May 2024 : Editorial
Editorial: First Regulatory Approval for Adoptive Cell Therapy with Autologous Tumor-Infiltrating Lymphocytes (TILs) – Lifileucel (Amtagvi)DOI: 10.12659/MSM.944927
Med Sci Monit 2024; 30:e944927
In Press
07 May 2024 : Clinical Research
Treatment of AVN-Induced Proximal Pole Scaphoid Nonunion Using a Fifth and Fourth Extensor Compartmental Ar...Med Sci Monit In Press; DOI: 10.12659/MSM.944553
16 Mar 2024 : Clinical Research
Diagnostic Efficiency of ACR-TIRADS Score for Differentiating Benign and Malignant Thyroid Nodules of Vario...Med Sci Monit In Press; DOI: 10.12659/MSM.943228
08 May 2024 : Clinical Research
Effect of Individualized PEEP Guided by Driving Pressure on Diaphragm Function in Patients Undergoing Lapar...Med Sci Monit In Press; DOI: 10.12659/MSM.944022
21 Mar 2024 : Clinical Research
Impact of Serum Vitamin D, B6, and B12 and Cognitive Functions on Quality of Life in Peri- and Postmenopaus...Med Sci Monit In Press; DOI: 10.12659/MSM.943249
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952