Key result
Early discharge (≤5 days) after isolated CABG did not significantly increase the rate of 30-day hospital readmission compared to late discharge (7.0% vs. 10.0%, p=0.211).
Why the study?
It was unknown whether early discharge after CABG is associated with increased rates of hospital readmission and emergency room presentation.
Does early discharge (≤5 days) compared to late discharge (>5 days) increase the risk of 30-day hospital readmission or ER presentation in adults undergoing isolated CABG?
Cohort (n=608)
No
Does early discharge (≤5 days) compared to late discharge (>5 days) increase the risk of 30-day hospital readmission or ER presentation in adults undergoing isolated CABG?
Absolute Event Rate: 7% vs 10%
p-value: p=0.211
Early discharge (≤5 days) after isolated CABG surgery appears safe and is not associated with an increased risk of 30-day hospital readmission or emergency room presentation.
Early discharge after CABG was not associated with higher 30-day readmission or ER visits; leaves open safety in unselected or higher-risk populations.
Objective: This study aimed to investigate whether early discharge after coronary artery bypass grafting (CABG) is associated with increased rates of hospital readmission and emergency room (ER) presentation. Methods: This retrospective cohort study utilized data from the Koşuyolu Adult Cardiac Surgery Quality Improvement Program database. Consecutive adults who underwent isolated CABG at a single institution between May 2023 and December 2023 were assessed for eligibility. Patients were excluded if they had surgery other than isolated CABG, experienced in-hospital mortality, or had a prolonged length of stay (>14 days) during index hospitalization. The study population was divided into early discharge (≤5 days) and late discharge (>5 days) groups. The primary endpoint was all-cause hospital readmission within 30 days of discharge, while the secondary endpoint was ER presentation for any reason within 30 days of discharge. Results: The final cohort included 608 patients (228 early-discharge, 380 late-discharge). Median age was 61 years (interquartile range, 54-67). Groups were balanced in terms of demographics, risk profile, operative details, and outcomes. Thirty-day rehospitalization and ER presentation rates were lower in the early discharge group compared to the late discharge group; however, the differences were statistically insignificant (7.0% vs. 10.0%, p=0.211; 25.4% vs. 29.5%, p=0.283; respectively). Multivariate logistic regression analysis identified postoperative mechanical ventilation duration, sternal wound infection, postoperative stroke, and discharge with atrial fibrillation as the strongest predictors of hospital readmission within 30 days of discharge (odds ratio [OR]=1.049, 95% confidence interval [CI] 1.000-1.100; OR=10.268, 95% CI 1.882-56.032; OR=39.891, 95% CI 1.980-803.624; OR=24.724, 95% CI 1.499-407.804; respectively). Conclusion: Early discharge after isolated CABG surgery was not associated with increased rates of hospital readmission or ER presentation within 30 days of discharge.
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Topçu et al. (2024) conducted a cohort in isolated coronary artery bypass grafting (CABG) (n=608). Early discharge (≤5 days) vs. Late discharge (>5 days) was evaluated on all-cause hospital readmission within 30 days of discharge (p=0.211). Early discharge (≤5 days) after isolated CABG did not significantly increase the rate of 30-day hospital readmission compared to late discharge (7.0% vs. 10.0%, p=0.211).
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