Frequency and Risk Factors of Unplanned 30-Day Readmission After Open Heart Surgeries: A Retrospective Study in a Tertiary Care Center

Almramhi, Khalid; Aljehani, Mohammed N; Bamuflih, Mohammed; AlGhamdi, Saad Abdulla; Banser, Sultan; Almousa, Abdullah M.; Alabdulwahab, Saleh A.; Al‐Ebrahim, Khaled E.

doi:10.1532/hsf.4875

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…Furthermore, strict surgical protocols and specific guidelines must be followed to minimize the occurrence of complications such as bleeding, sternal wound infection, acute kidney injury, diaphragmatic paralysis, and pleural effusion, requiring multiple unexpected emergency room readmissions. Moreover, the future of cardiac surgery is rapidly changing, and interventional surgery is promising for improving postoperative QoL [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Clinical and Sociodemographic Factors on Quality of Life Following Coronary Artery Bypass Grafting: A Mixed-Methods Study

Alzahrani,

AlAssiri,

Al-Ebrahim

et al. 2024

Cureus

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Introduction: Coronary artery bypass grafting (CABG) is an essential surgical management modality for patients with coronary artery disease. Health-related quality of life (HRQoL) has become important because of the significant decrease in the mortality rate associated with CABG. We aimed to explore the factors that affect the quality of life after CABG. Methods: This study used a descriptive correlational design to assess the determinants of HRQoL using the 36-item Short Form Health Survey questionnaire (SF-36). Patients who underwent CABG at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, between March 2015 and December 2021 were enrolled in this study. Overall, 275 participants were eligible for our study, of which 84 were found to be valid for analysis. Phone contacts were made directly with the patient after briefly explaining the study. Scores and clinical data were investigated using multivariable linear regression analysis. Results: Subscales of role limitations due to physical issues had the lowest mean scores, followed by vitality and general health (57.4 ± 44.7; 60.4 ± 25.6; 64.1 ± 22.6), respectively. However, social functioning (78.9 ± 29.0) and pain (75.1 ± 29.9) had the highest scores of all subscales. A history of congestive heart failure (CHF) was independently associated with lower scores for physical role limitations (p = 0.021), vitality (p = 0.001), general health (p< 0.001), and mental health (p = 0.011). Lower mental health scores were also predicted by being a widow (p = 0.030), whereas lower general health scores were predicted by being unemployed (p = 0.001) and having a peripheral vascular disease (PVD) (p = 0.043). Additionally, the development of postoperative complications was an independent predictor of lower physical functioning (p = 0.028) and vitality (p = 0.043). Regarding the number of grafts, cardiopulmonary bypass, and cross-clamp time, no significant impact was found on any of the SF-36 subscales (p> 0.05). Conclusion: The postoperative decline in HRQoL was attributed to comorbidities such as CHF and PVD, postoperative complications including bleeding and wound infection, as well as unemployment and widowed status. Therefore, choosing the appropriate patients for surgery and post-discharge follow-up may enhance HRQoL.

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Section: Discussionmentioning

confidence: 99%

Impact of Clinical and Sociodemographic Factors on Quality of Life Following Coronary Artery Bypass Grafting: A Mixed-Methods Study

Alzahrani,

AlAssiri,

Al-Ebrahim

et al. 2024

Cureus

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“…SWI accounts for about 50% of emergency room revisits post-cardiac surgery and unplanned readmission [Almramhi 2022].…”

Section: Discussionmentioning

confidence: 99%

Sternal Wound Infection Following Open Heart Surgery: Incidence, Risk Factor, Pathogen, and Mortality

Al‐Ebrahim

Alsheikh

Alshehri

et al. 2023

HSF

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Background: Due to its high morbidity and mortality after open-heart surgery, sternal wound infection (SWI) is one of the most important consequences to avoid and manage. Aim: To assess the incidence, risk factor, causative organisms, and mortality of SWIs in patients who had open-heart surgery over a 9-year period at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Methods: A retrospective study was done on 634 patients who underwent open heart surgery. Data was collected, including patient demographics, BMI, blood group, diabetes, hyperlipidemia, COPD, previous cardiac surgery, previous myocardial infarction, duration of the operation, blood transfusion during the operation, hospital length of stay, and bypass time with each type of sternal wound infection. Results: The incidence of SSWI and DSWI was 8.6% and 4.1%, respectively. Coagulase-negative staphylococcus was the most frequently isolated organism from SSWI and DSWI patients. A concomitant diabetes mellitus that necessitates blood transfusion was identified as one of the risk variables for SSWI in a multivariate regression study. While concomitant diabetes, being a woman, and a lengthy hospital stay were independently linked with DSWI. Compared with the SSWI group, the 30-day mortality rate for DSWI patients was 3.8% as opposed to 3.7%, and the difference in survival was not statistically significant. Having an older, longer bypass time, and postoperative problems were independent risk factors for 30-day mortality. Conclusion: Future studies in various healthcare settings are required in order to generalize the results because this was a single center study.

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“…Further, research and health education are warranted to identify risk factors for this gender bias in order to institute medical and surgical interventions to mitigate this problem. Strict protocols and guidelines are followed and enforced to minimize certain complications like acute kidney injury, exploration for postoperative bleeding, and unexpected emergency readmission after discharge [28][29][30]. Prospective randomized studies are necessary to compare the results of interventional coronary procedures to conventional surgery in females.…”

Section: Discussionmentioning

confidence: 99%

Effect of Gender on Postoperative Outcome and Duration of Ventilation After Coronary Artery Bypass Grafting (CABG)

Alamri¹,

Alotaibi²,

Alghatani³

et al. 2023

Cureus

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Introduction: The study assessed coronary artery bypass grafting (CABG) postoperative outcomes and associated factors in Saudi male and female patients. This was a retrospective cohort of patients who underwent CABG at the King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, from January 2015 to December 2022.Results: We included 392 patients, of whom 63 (16.1%) were female. Female undergoing CABG were significantly older (p=0.0001), had a significantly higher incidence of diabetes (p=0.0001), obesity (p=0.001), hypertension (p=0.001), and congestive heart failure (p=0.005), with a smaller body surface area (BSA) (p=0.0001) than male. Though renal dysfunction, previous cerebrovascular accident/transient ischemic attack (CVA/TIA), and myocardial infarction (MI), incidences were similar in both genders. Females were at significantly higher risk of mortality (p=0.0001), longer hospital stay (p=0.0001), and prolonged ventilation (p=0.0001). Preoperative renal dysfunction was the only statistically significant predictor of postoperative complications (p=0.0001). Female gender and preoperative renal dysfunction, were significant independent predictors of postoperative mortality and prolonged ventilation (p=0.005).Conclusion: This study's findings indicated that females have worse CABG outcomes and a higher risk of morbidities and complications. Uniquely our study showed a higher incidence of prolonged ventilation in females postoperatively.

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Frequency and Risk Factors of Unplanned 30-Day Readmission After Open Heart Surgeries: A Retrospective Study in a Tertiary Care Center

Cited by 5 publications

References 15 publications

Impact of Clinical and Sociodemographic Factors on Quality of Life Following Coronary Artery Bypass Grafting: A Mixed-Methods Study

Impact of Clinical and Sociodemographic Factors on Quality of Life Following Coronary Artery Bypass Grafting: A Mixed-Methods Study

Sternal Wound Infection Following Open Heart Surgery: Incidence, Risk Factor, Pathogen, and Mortality

Effect of Gender on Postoperative Outcome and Duration of Ventilation After Coronary Artery Bypass Grafting (CABG)

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