Predictors of hospital readmission two years after coronary artery bypass grafting.
OBJECTIVE
To determine the clinical factors before, and in association with, coronary artery bypass grafting (CABG) that increase the risk of readmission to hospital in the first two years after surgery.


METHODS
All patients in western Sweden who had CABG without simultaneous valve surgery between 1 June 1988 and 1 June 1991.


METHODS
All patients who were readmitted to hospital were evaluated by postal inquiry and hospital records.


RESULTS
A total of 2121 patients were operated on, of whom 2037 were discharged from hospital. Information regarding readmission was missing in four patients, leaving 2033 patients; 44% were readmitted to hospital. The most common reasons for readmission were angina pectoris and congestive heart failure. There were 12 independent significant predictors for readmission: clinical history (a previous history of either congestive heart failure or myocardial infarction, or CABG); acute operation; postoperative complications (time in intensive care unit greater than two days, neurological complications); clinical findings four to seven days after the operation (arrhythmia, systolic murmur equivalent to mitral regurgitation); medication four to seven days after the operation (antidiabetics, diuretics for heart failure, other antiarrhythmics (other than beta blockers, calcium antagonists, and digitalis), and lack of treatment with aspirin).


CONCLUSIONS
44% of patients were readmitted to hospital two years after CABG. The most common reasons for readmission were angina pectoris and congestive heart failure. Four clinical markers predicted readmission: clinical history; acute operation status; postoperative complications; and clinical findings and medication four to seven days after operation.
Herlitz
J
J
Division of Cardiology, Sahlgrenaka University Hospital, Göteborg, Sweden.
Albertsson
P
P
Brandrup-Wognsen
G
G
Emanuelsson
H
H
Haglid
M
M
Hartford
M
M
Hjalmarson
A
A
Karlson
B W
BW
Karlsson
T
T
Sandén
W
W
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000787:Angina Pectoris / Q000150:complications; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D004232:Diuretics / Q000627:therapeutic use; D004630:Emergencies; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D011184:Postoperative Period; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D004232:Diuretics; D001241:Aspirin