Key result
Preoperative mechanical ventilation is linked to a ~4-fold increase in 1-year readmissions after CHD surgery.
Why the study?
The rate, causes, and risk factors of unplanned hospital readmission following surgical repair of congenital heart defects were not well established.
What are the rates and risk factors for unplanned hospital readmission following surgical repair of congenital heart defects?
Cohort (n=189)
No
What are the rates and risk factors for unplanned hospital readmission following surgical repair of congenital heart defects?
Odds Ratio: 3.95 (95% CI 1.5–10.4)
Absolute Event Rate: 40.7% vs 11.7%
p-value: p=0.005
Unplanned readmission after congenital heart disease surgery occurs in approximately 16% of patients within one year, driven independently by preoperative mechanical ventilation and prolonged postoperative length of stay.
May inform risk stratification after congenital heart surgery; leaves open prospective validation of prevention strategies.
OBJECTIVES: To estimate the rate of unplanned hospital readmission following surgical repair of congenital heart defects (CHD) and investigate the related causes and risk factors. METHODS: A retrospective chart review of all the patients who underwent surgical repair of CHD at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. The study outcome consisted of any hospital admission during the 12 months following the first reparative surgery. Exclusion criteria included planned admissions. Patients' demographic and readmission data as well as the perioperative data were collected and analyzed as factors and predictors of unplanaed readmission. RESULTS: After the exclusion of the deceased patients, a total of 189 patients were included. The readmission rate was 15.9% during a one-year period following surgery. There was a significant association between the probability of readmission and preoperative mechanical ventilation (MV) (p less than 0.001), intraoperative complications (p=0.025), prolonged postoperative length of stay (LOS) (p less than 0.001), early postoperative complication (p=0.007), long postoperative MV stay, and drain tube stay (p=0.011). Significant predictors of unplanned readmission included young age (1-12 months) and low weight at surgery (less than 5kg), preoperative MV, intraoperative complications, postoperative LOS ≥10 days, pediatric intensive care unit stay, MV stay, drain tube stay, infections, respiratory complication, and feeding problems. Only the preoperative MV and LOS greater than 10 days were the independent risk factors. CONCLUSION: Readmission rates were similar to those reported in other studies. Future studies are warranted to investigate suitable actions to alleviate the modifiable risk factors, such as postoperative complications.
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Ahmad Saeed Azhar (2019) conducted a cohort in Congenital heart disease (n=189). Preoperative mechanical ventilation vs. No preoperative mechanical ventilation was evaluated on Unplanned hospital readmission within 12 months (OR 3.95, 95% CI 1.50-10.40, p=0.005). Preoperative mechanical ventilation independently increased the odds of unplanned hospital readmission within 12 months following congenital heart disease surgery (OR 3.95).
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