心脏动脉旁路再植术后30天内约15%患者需复诊[英文]
http://www.100md.com
Over 15% of Patients Readmitted to Hospital Within 30 Days of Coronary Artery Bypass Graft Surgery
JAMA 2003;290:773-780.
Hospital readmissions within 30 days of coronary artery bypass graft (CABG) surgery occurred in 15.3% of the patients discharged alive. Of these readmissions, 12.9% were related to the CABG surgery, according to data collected from New York state hospitals over 1 year.
"Readmission to hospital shortly after CABG is a common problem," writes Edward L. Hannan, PhD, of State University of New York, Rensselaer, United States and colleagues. They used New York State’s Cardiac Surgery Reporting System to examine the causes for hospital readmission within 30 days for all patients undergoing CABG surgery in 1999. Of 16,325 total patients, 2111 were readmitted to a hospital within 30 days of CABG surgery for reasons related to the surgery.
Of the readmissions, post-surgical infection was reported in 598 patients (28.3%), 331 patients (15.7%) had heart failure, 166 patients (7.9%) experienced myocardial ischaemia/acute myocardial infarction, while 163 patients (7.7%) had arrhythmias. During readmission, 2.7% of the patients died. After readmission, 11.7% of the patients were discharged to a rehabilitation/acute care facility and 78.7% were discharged to home.
The investigators found that patients who were older, female, or had larger body surface areas were significantly more likely than their counterparts to be readmitted within 30 days post-CABG. Experiencing a myocardial infarction within 1 week before CABG surgery was a significant independent predictor of readmission, as were comorbidities including femoral/popliteal disease, congestive heart failure, chronic obstructive pulmonary disease, diabetes, hepatic failure, and dialysis.
After controlling for patient risk factors, the investigators found that having surgery at a hospital with a risk-adjusted mortality rate in the highest decile as well as having surgery performed by a surgeon who performs less than 100 CABG surgeries annually were related to higher readmission rates among the patient population. Additionally, a post-CABG hospital stay of more than 5 days and post-CABG discharge to a nursing home or rehabilitation/acute care facility were associated with higher readmission rates., http://www.100md.com
JAMA 2003;290:773-780.
Hospital readmissions within 30 days of coronary artery bypass graft (CABG) surgery occurred in 15.3% of the patients discharged alive. Of these readmissions, 12.9% were related to the CABG surgery, according to data collected from New York state hospitals over 1 year.
"Readmission to hospital shortly after CABG is a common problem," writes Edward L. Hannan, PhD, of State University of New York, Rensselaer, United States and colleagues. They used New York State’s Cardiac Surgery Reporting System to examine the causes for hospital readmission within 30 days for all patients undergoing CABG surgery in 1999. Of 16,325 total patients, 2111 were readmitted to a hospital within 30 days of CABG surgery for reasons related to the surgery.
Of the readmissions, post-surgical infection was reported in 598 patients (28.3%), 331 patients (15.7%) had heart failure, 166 patients (7.9%) experienced myocardial ischaemia/acute myocardial infarction, while 163 patients (7.7%) had arrhythmias. During readmission, 2.7% of the patients died. After readmission, 11.7% of the patients were discharged to a rehabilitation/acute care facility and 78.7% were discharged to home.
The investigators found that patients who were older, female, or had larger body surface areas were significantly more likely than their counterparts to be readmitted within 30 days post-CABG. Experiencing a myocardial infarction within 1 week before CABG surgery was a significant independent predictor of readmission, as were comorbidities including femoral/popliteal disease, congestive heart failure, chronic obstructive pulmonary disease, diabetes, hepatic failure, and dialysis.
After controlling for patient risk factors, the investigators found that having surgery at a hospital with a risk-adjusted mortality rate in the highest decile as well as having surgery performed by a surgeon who performs less than 100 CABG surgeries annually were related to higher readmission rates among the patient population. Additionally, a post-CABG hospital stay of more than 5 days and post-CABG discharge to a nursing home or rehabilitation/acute care facility were associated with higher readmission rates., http://www.100md.com