Readmission to intensive care unit after cardiac surgery - a single center experience with 5983 patients

Aims: Readmission to intensive care unit (ICU) after cardiac surgery is associated with higher costs and impaired clinical outcome. Clinical data and outcome of readmitted patients were analyzed and perioperative and perioperative prognostic variables of ICU readmission evaluated. Patients: 5983 patients who underwent CABG and/or valve or aortic surgery between 2007 and 2009 were reviewed retrospectively. The reasons for readmission and the postoperative course were analyzed. Furthermore, perioperative risk factors for readmission were determined by multivariate regression analysis. ariables of ICU readmission evaluated Results: 5983 patients were discharged from the ICU, 5.6% (335) of these patients required a second stay in the ICU. The readmission rate was 3.6% following CABG and 7.8% following valve or aortic±CABG (p<0.0001). Of the patients who were not readmitted, 3.8% died in hospital, compared to 16.1% in group r (p<0.0001). After readmission, the mean length of stay in hospital was 26.1±5.9 days and 12.5±5.1 days for all other patients (p<0.05). Main reasons for readmission were respiratory failure (27%) and cardiovascular instability (32%), neurological complications (11%), sepsis (8.6%), bleeding (11.9%) and others (9.5%). Multivariate logistic regression analysis revealed preoperative renal insufficiency, pulmonary hypertension, reexploration for bleeding, postoperative renal failure and prolonged intubation were independent predictors for readmission. Conclusions: Readmission to ICU is particular related with valve/combined surgery and associated with impaired outcome. Predictive renal and pulmonary risk factors indicate particular need of preoperative preconditioning and patient selection.