Readmission after cardiac operations: Prevalence, patterns, and predisposing factors

Objectives: This study was undertaken (1) to determine the prevalence of ho spital readmission within 1 month of discharge after cardiac operations, (2 ) to categorize diagnoses responsible for readmission, and (3) to examine p redischarge patient factors that influenced readmission, Methods: Data at 1 month after discharge were obtained for 1665 (98.4%) of 1692 patients who underwent cardiac operations between January 1996 and July 1998, Results: T wo hundred twenty-five patients (13.5%) were readmitted to a hospital withi n a 1-month period after discharge, Forty-eight percent of readmissions wer e to other hospitals. The most common readmission problems were congestive heart failure (15.6%), atrial fibrillation (12.9%), chest pain (12.0%), wou nd problems (10.2%), and gastrointestinal problems (8.0%), Hospital dischar ge on or before the fifth postoperative day was associated with a lower pre valence of subsequent readmission, The independent predictors of a readmiss ion for congestive heart failure mere postoperative stay longer than 5 days , diabetes, New York Heart Association functional class IV, preoperative co ngestive heart failure, total blood product use, the need for postoperative inotropes, body mass index greater than 28 kg/m(2), and reoperation for bl eeding, Conclusions: The prevalence of rehospitalization during the first m onth after discharge is not trivial. Other than postoperative atrial fibril lation, readmission is probably the single most likely adverse event to bef all a patient in the early postoperative period. Patients who are discharge d early do not appear to be at increased risk. Patterns in readmission diag noses suggest opportunities for preventive strategies.