Prospective correlates of early (30 day) readmissions on a Cardiothoracic Surgery Service.
Known to vary widely among hospitals for unclear reasons, early readmissions are associated with higher mortality and are suspected to frequently be due to inadequate discharge preparation/planning. It has been previously documented that the strongest and most consistent predictor of early readmissions in CHF patients is chronic cognitive impairment, and compensatory assistance with adherence on discharge improves early readmission rates. Prospective observational study. The present investigation examined multiple putative perioperative predictors of early readmission in a hospitalized Cardiothoracic Surgery Service. A subtest of the Mini-Cog, Short Term Memory, was the strongestunivariate predictor of early readmissions (p < .001), but the overall Mini-Cog (p = .024), Age (p = .045), Number of Admissions over the Preceding Year (p = .036), an Anxiety Scale (p = .035), Years of Education (p = .055) and a Depression Scale (p = .056) also demonstrated covariation. In a Logistic Regression, only Short Term Memory survived as a predictor variable (p = .007), correctly classifying 76% of patients. Chronic cognitive impairment is a predictor of early readmissions in Cardiothoracic patients. A brief bedside exam interpreted in medical context may permit identification of patients requiring familial assistance for adherence on discharge.
a Department of Behavioral Health , Henry Ford Hospital/WSU , Detroit , MI , USA.
Mark W
MW
Ketterer
b Behavioral Health , Henry Ford Health System , Detroit , MI , USA.
Mansi
M
Chawa
c Division of Cardiothoracic Surgery , Henry Ford Hospital , Detroit , MI , USA.
Gaetano
G
Paone
D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data*; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data*; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D056348:Emotional Intelligence; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014481:United States
Readmissions; cardiothoracic; cognitive impairment; surgery; utilization; vascular