Kolat, Philipp and Guttenberger, Patricia and Ried, Michael and Kapahnke, Julia and Haneya, Assad and Schmid, Christof and Diez, Claudius (2020) ICU Readmission after Cardiac Surgery-Still a Matter of Concern? THORACIC AND CARDIOVASCULAR SURGEON, 68 (05). pp. 384-388. ISSN 0171-6425, 1439-1902
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Background Despite improvements in diagnostics and perioperative care, readmission to intensive care unit (ICU) after cardiac surgery is still a severe drawback for patients with considerable morbidity, mortality, and costs. Aim of this retrospective analysis was to disentangle independent risk factors for ICU readmission. Material and Methods Between 01/2004 and 12/2012, 336 out of 9,555 (3.5%) patients undergoing cardiac surgery at the Department of Cardiothoracic Surgery in Regensburg (Germany) were readmitted to ICU. A matched-pair analysis (readmission vs control group) was conducted, matching for gender, age, and surgical procedure. Operations included coronary artery bypass grafting, valve reconstruction/replacement, aortic surgery, combined procedures, and others. Mean follow-up was 6.2 +/- 2.3 years. Results Median age of the readmitted patients was 71 years (65; 76), and the majority was male (67.9%). Median logistic Euroscore as a parameter for perioperative risk was significantly higher as compared with the control group (5.8 vs 5.2,p = 0.045) as was the prevalence of comorbidities including hypertension, chronic obstructive pulmonary disease, prior myocardial infarction, stroke, and PAOD. Most common reasons for readmission were cardiopulmonary instability (27.4%), respiratory failure (20.8%), and surgery for deep sternal infection (8.6%). Twenty-one percent required more than one readmission. Overall mortality was significantly higher in readmitted patients (21.1 vs 12.5%). Conclusions In conclusion, readmission to the ICU after cardiac surgery is a rare complication that is still associated with excessive mortality. Establishment of an intermediate care unit proved to be an excellent means to reduce ICU stay without endangering post-surgery patients and significantly reduced the ICU readmission rate.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INTENSIVE-CARE-UNIT; QUALITY-OF-LIFE; LONG-TERM SURVIVAL; STAY; RISK; EUROSCORE; PROFILES; OUTCOMES; cardiac; intensive care; outcomes; mortality; morbidity; readmission |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 17 Mar 2021 10:46 |
| Last Modified: | 17 Mar 2021 10:46 |
| URI: | https://pred.uni-regensburg.de/id/eprint/44117 |
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