Predictors of Hospital Readmission within 30 Days after Coronary Artery Bypass Grafting: Data Analysis of 2,272 Brazilian Patients

Abstract Introduction: In order to reduce readmission rates after coronary artery bypass grafting (CABG), its predictors should be known in different contexts. The objective of this study was to identify predictive factors of hospital readmission within 30 days after CABG in a Brazilian center. Methods: A secondary analysis of an electronic database of patients submitted to isolated CABG was performed. The relationship between readmission within 30 days and demographic, anthropometric, clinical, and surgery-related characteristics was investigated by univariate analyses. Predictors were identified by multiple logistic regression. Results: Data from 2,272 patients were included, with an incidence of readmission of 8.6%. The predictors of readmission were brown skin color (Beta=1.613; 95% confidence interval [CI] 1.047-2.458; P=0.030), African-American ethnicity (Beta=0.136; 95% CI 0.019-0.988; P=0.049), chronic kidney disease (Beta=2.214; 95% CI 1.269-3.865; P=0.005), postoperative use of blood products (Beta=1.515; 95% CI 1.101-2.086; P=0.011), chronic obstructive pulmonary disease (Beta=2.095; 95% CI 1.284-3.419; P=0.003), and use of acetylsalicylic acid (Beta=1.418; 95% CI 1.000-2.011; P=0.05). Preoperative antibiotic prophylaxis (Beta=0.742; 95% CI 0.5471.007; P=0.055) was marginally significant. Conclusion: The predictors identified may support a closer postoperative follow-up and individualized planning for a safe discharge.

摘要：为降低冠状动脉旁路移植术（coronary artery bypass grafting, CABG）后的再入院率，需明确不同临床场景下的相关预测因素。本研究旨在明确巴西某医疗中心内，接受单纯冠状动脉旁路移植术患者术后30天内院内再入院的预测因素。
方法：本研究对接受单纯冠状动脉旁路移植术患者的电子病历数据库开展二次分析。通过单因素分析探究30天内再入院与患者人口学特征、人体测量学指标、临床基线情况及手术相关特征之间的关联，并采用多因素Logistic回归分析筛选独立预测因素。
结果：本研究共纳入2272例患者的临床数据，整体再入院发生率为8.6%。最终识别的再入院预测因素包括：棕肤色（Beta=1.613；95%置信区间[confidence interval, CI] 1.047~2.458；P=0.030）、非裔族群（Beta=0.136；95%CI 0.019~0.988；P=0.049）、慢性肾脏病（Beta=2.214；95%CI 1.269~3.865；P=0.005）、术后输注血液制品（Beta=1.515；95%CI 1.101~2.086；P=0.011）、慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD；Beta=2.095；95%CI 1.284~3.419；P=0.003）及乙酰水杨酸（acetylsalicylic acid, ASA；Beta=1.418；95%CI 1.000~2.011；P=0.05）。术前预防性使用抗生素（Beta=0.742；95%CI 0.547~1.007；P=0.055）呈临界显著性关联。
结论：本研究识别的再入院预测因素，可为术后加强随访管理及制定个体化安全出院方案提供参考依据。