Key result
Thirty-day readmission reaches ~8% after cardiac surgery, driven by obesity, smoking, and inotrope use.
Why the study?
Early readmissions after cardiac surgery are common, costly, and potentially avoidable, making their reduction necessary to improve healthcare efficiency.
What is the magnitude of and factors associated with 30-day hospital readmission after cardiac surgery in a specialized hospital in Ethiopia?
Cohort (n=324)
No
What is the magnitude of and factors associated with 30-day hospital readmission after cardiac surgery in a specialized hospital in Ethiopia?
The study demonstrates an 8.0% 30-day readmission rate following cardiac surgery in Ethiopia, identifying high-risk patient characteristics such as obesity, smoking, and complicated post-operative courses.
May guide risk stratification for readmission after cardiac surgery in Ethiopia; hypothesis-generating and requires prospective validation before practice change.
Introduction: Early hospital readmissions after cardiac operations are common, can vary from 7% to 21%, and are likely related to patient co-morbidity and perioperative care. Hospital readmissions are costly and potentially avoidable. Reducing hospital readmissions after cardiac surgery is necessary as part of the solution to improving efficiency in health care. Methods: An institution-based retrospective chart review was conducted among 324 patients’ charts with the complete document from October 2013 to October 2020. The data were analyzed using SPSS. Both binary and multiple logistic regressions were run to identify associated factors at. PV< 0.05 with a 95% confidence interval (CI), which was considered statistically significant. Results: The overall readmission rate was 8.0%. Fifty-one (15.7%) patients had mitral regurgitation history before surgery. About 207 (63.9%) patients were admitted with the preoperative diagnosis of chronic rheumatic valvular heart disease. Mitral valve (MV) replacement was done in 110 (34%), MV repair in 64 (19.8%), and atrial septal defect closure in 36 (11.1%). This study revealed that pericardial effusion was most common, accounting for 2.4%. Patients who were currently or ever smokers [adjusted odds ratio (AOR) 11.57, 95% CI (1.87– 75.16.6)], obese patients [AOR 14.0, 95% CI (1.11– 176.3)], and patients whose length of hospital stay (LOS) was 10– 14 days post-operatively [AOR 4.89, 95% CI (1.83– 13.06)] were identified as factors that increase the likelihood of 30-day readmission among patients who underwent cardiac surgery. Conclusion: The magnitude of 30-day readmission after cardiac surgery in Tikur Anbessa Specialized Hospital Cardiac Centre, Ethiopia, was moderate, with identified factors of left ventricular ejection fraction, obese patients, history of smoking, history of dyslipidemia, postoperative LOS, and postoperative inotropic drug need all increasing the likelihood of readmission within 30 days after cardiac surgery. Therefore, policymakers and health planners would develop strategies and protocol guidelines to improve the quality of cardiac surgery and prevent readmission after cardiac surgery.
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Demissie et al. (2023) conducted a cohort in Cardiac surgery (n=324). Cardiac surgery was evaluated on 30-day hospital readmission (95% CI 5.2-11.1). The overall 30-day readmission rate after cardiac surgery was 8.0%, with obesity, history of smoking, history of dyslipidemia, prolonged postoperative length of stay, and postoperative inotropic drug use identified as significant risk factors.
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