Abstract 13474: Causes of 30-Day Readmission After Cardiac Surgery in Northern New England
Background. There is a high rate of readmission within 30 days following discharge from a hospitalization for cardiac surgery. This is associated with increased morbidity, mortality, and cost of care. A systematic review of the medical record could identify details of the process of care and causes of readmission that are actionable and could lead to a decrease in rates of readmission.
Methods. From our regional registry of open heart surgery, we identified 268 consecutive patients readmitted within 30 days (mean=11 days) of their index procedure. Trained health professionals systematically abstracted the records of their index and readmission hospitalizations, information that was merged to existing registry data.
Results. Readmitted patients had more comorbid conditions at the time of their index procedure and were more likely to have valve surgery (30.2% v 23.2%). Early follow-up appointments were recommended for all patients but variably scheduled (CT surgery 54.1%; PCP 1.1%). A minority of patients (23.1%) were seen as outpatients prior to their readmission. Infections (24%), effusions (20%), and rhythm disturbances (16%) were the most common primary causes of readmission (Figure). Common secondary causes of readmission included CHF/SOB (28%) and effusions (18%).
Conclusions. Root cause analysis of causes of readmission following open heart surgery is feasible. Our pilot study suggests that more attention to volume status and management of effusions could substantially decrease rates of readmission.
- © 2011 by American Heart Association, Inc.