Exploring Recidivism in Cardiac Surgical ICU: Can this Understanding Translate to Enhanced Patient Outcomes?
Humans
Male
Female
Patient Readmission
/ statistics & numerical data
Middle Aged
Cardiac Surgical Procedures
Case-Control Studies
Intensive Care Units
Postoperative Complications
/ epidemiology
Aged
Risk Factors
Adult
India
/ epidemiology
Length of Stay
/ statistics & numerical data
Treatment Outcome
Critical Care
/ statistics & numerical data
Journal
Annals of cardiac anaesthesia
ISSN: 0974-5181
Titre abrégé: Ann Card Anaesth
Pays: India
ID NLM: 9815987
Informations de publication
Date de publication:
01 Oct 2024
01 Oct 2024
Historique:
received:
11
03
2024
accepted:
25
05
2024
medline:
4
10
2024
pubmed:
4
10
2024
entrez:
4
10
2024
Statut:
ppublish
Résumé
The need for reinstitution of intensive care unit (ICU) care ("recidivism") in post-cardiac surgery patients is associated with increased morbidity, mortality, resource use, and healthcare costs. Recidivism is propounded as a quality indicator of ICU care. There is a paucity of studies from India regarding cardiac surgical ICU readmissions, their outcomes, and risk factors. Nested case-control study including 1,711 consecutive adult patients who underwent cardiac surgery over a two-year period at a tertiary care institute. The patients were grouped into recidival (R) and control (C) groups. The reasons for readmission, outcomes, and predictive risk factors were analyzed. Fifty-four of 1,711 (3.1%) patients were readmitted to ICU, main reasons being cardiac arrhythmias (24, 41%), pericardial effusion (9, 15.2%), and infection (8, 13.5%). Readmission was significantly higher for valvular interventions (39 patients, 24.3%, mitral valve 25 patients) than coronary artery bypass grafting (13, 10.6%), P value 0.003*. On multivariate analysis, EuroSCORE 2 (>5), age, surgical reexploration, postoperative pulmonary complications, and infections were independently associated with a need for ICU readmission. The mortality rate among the readmitted patients was 7.4% compared to 1.4% overall mortality. The mean total postoperative length of stay was significantly longer for recidival patients (17.6 ± 14 days vs 7.6 ± 2.4 days; P < 0.0001). Recidivism is associated with longer hospital stay, suboptimal outcomes as well higher risk of mortality. Postoperative cardiac dysrhythmia was the most common cause of recidivism in our cohort. Early identification of patients at risk for recidivism and timely management of cardiopulmonary complications can translate to better outcomes.
Identifiants
pubmed: 39365131
doi: 10.4103/aca.aca_68_24
pii: 00660469-202427040-00007
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
330-336Informations de copyright
Copyright © 2024 Copyright: © 2024 Annals of Cardiac Anaesthesia.
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