Document Detail


Readmission to the intensive care unit after fast-track cardiac surgery: an analysis of risk factors and outcome according to the type of operation.
MedLine Citation:
PMID:  20719721     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: In the present study, we investigated risk factors for intensive care unit (ICU) readmission after fasttrack cardiac surgery and analyzed outcome data according to the type of surgical procedure.
METHODS: Between 1999 and 2008, we prospectively enrolled 4270 consecutive patients who underwent isolated coronary artery bypass grafting (CABG) (CABG group, n = 3754), isolated valve surgery (valve group, n = 353), or combined CABG and valve surgery (CABG + valve group, n = 163) in the study.
RESULTS: Ninety-eight patients (2.2%) were readmitted to the ICU. Of these patients, 73 were in the CABG group (1.9% of this group), 16 were in the valve group (4.5%), and 9 were in the CABG + valve group (5.5%). The main reason for ICU readmission in all groups was respiratory distress. A multivariate analysis showed that the independent risk factors for ICU readmission in the CABG group were an age >65 years (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.5-5.4; P = .001), peripheral arterial disease (OR, 2.7; 95% CI, 1.2-6.1; P = .016), and drainage >500 mL (OR, 2.5; 95% CI, 1.2-5.1; P = .009). The independent risk factors for the valve group included only preoperative congestive heart failure (OR, 3.9; 95% CI, 1.3-11.7; P = .01). No independent risk factor was defined for the CABG + valve group. Mortality was significantly higher among the readmitted patients in all groups.
CONCLUSIONS: The risk factors for readmission after cardiac surgery with fast-track recovery may differ according to the type of operation. A strict control of volume balance and blood transfusion may further help prevent the occurrence of the most frequent cause of readmission, respiratory failure.
Authors:
Fevzi Toraman; Sahin Senay; Umit Gullu; Hasan Karabulut; Cem Alhan
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  13     ISSN:  1522-6662     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-19     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E212-7     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Reanimation, School of Medicine, Acibadem University, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiac Surgical Procedures / adverse effects*,  methods*,  mortality
Coronary Artery Bypass / adverse effects
Coronary Artery Disease / complications,  surgery*
Heart Failure / complications
Heart Valve Diseases / complications,  surgery
Heart Valves / surgery*
Humans
Intensive Care Units*
Middle Aged
Multivariate Analysis
Patient Readmission*
Peripheral Arterial Disease / complications
Postoperative Care
Prospective Studies
Respiratory Insufficiency / etiology
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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