Utilization of Emergency and Hospitalization Care after Coronary Artery Bypass Surgery for Patients with Ischemic Heart Disease

Abstract

This retrospective follow-up study explored the status of patients with myocardial infarction with regard to the likelihood of being readmitted to the hospital within 30 days after undergoing coronary artery bypass surgery (CABG) and their survival status within one year of the procedure.The rate of readmission within 30 days was 10.7% (167/1,575), primarily due to surgical wound infection (11.3% of readmission cases), ischemic heart disease (10.3%), and heart failure (8.7%). The readmission group consisted mainly of older males with a high comorbidity index. No significant differences existed between the two groups with regard to case distribution, hospital level, tenure of physicians, or teaching status of the hospitals. Most subsequent emergency department visits one month after surgery involved older male patients with a high comorbidity index. Compared to patients in the non-emergency group, those in the emergency group had longer hospital stays but lower mortality rates. Males constituted a higher proportion of survivors at one year post CABG, with age and comorbidity index being the primary variables affecting the risk of death.The National Health Insurance may adopt the policy of increasing payments for medical institutions that avoid readmission within 30 days post CABG in order to encourage better patient care and avoid the costs associated with readmission.

Patient and hospital factors associated with 30-day readmissions after coronary artery bypass graft (CABG) surgery: a systematic review and meta-analysis

“…Characteristics of all 53 studies [ 7 , 8 , 11 – 14 , 20 – 66 ] included in this systematic review are given in Table 1 . Forty studies [ 7 , 8 , 11 – 14 , 20 – 26 , 28 – 37 , 39 – 44 , 46 – 49 , 52 , 54 , 58 , 59 , 62 , 64 , 65 ] (75% of all included studies) were from the USA.…”

“…Forty studies [ 7 , 8 , 11 – 14 , 20 – 26 , 28 – 37 , 39 – 44 , 46 – 49 , 52 , 54 , 58 , 59 , 62 , 64 , 65 ] (75% of all included studies) were from the USA. Most studies [ 7 , 8 , 11 – 14 , 20 , 21 , 25 , 27 , 32 , 33 , 35 – 37 , 39 – 42 , 44 , 46 – 49 , 52 , 58 , 59 , 61 , 63 , 65 , 66 ] ( n = 31) were based on administrative data aggregated across multiple sites and 22 studies [ 22 – 24 , 26 , 28 – 31 , 34 , 38 , 43 , 45 , 50 , 51 , 53 – 57 , 60 , 62 , 64 ] used medical records from either a single center or multiple centers. The included studies varied widely in sample size (range: 110 to 1,116,991).…”

“…Twenty-three studies [ 8 , 13 , 28 , 31 , 35 , 36 , 39 – 41 , 43 , 46 , 48 , 50 , 52 , 54 , 55 , 57 , 58 , 60 , 62 – 64 , 66 ] reported the causes of 30-day readmission after CABG (Fig. 4 ).…”

Contribution of the polymorphism rs1800469 of transforming growth factor β in the development of myocardial infarction: meta-analysis of 5460 cases and 8413 controls (MOOSE-compliant article)

“…[1,2] There are approximately 17.5 million deaths from CAD-related diseases in 2012. [3] Identification of subjects at risk for CAD/MI and gaining insights into the pathogenesis of them remain a tremendous challenge. Therefore, early-phase screening of risk factors can be an effective strategy of primary prevention of the development of CAD and MI.…”

Efficacy of Cognitive Behavioral Therapy for Heart Failure

“…2,12) These patients have a constant risk of hospitalization or death. 8,[13][14][15] Talking therapies such as cognitive behavioral therapy become increasingly important for patients with heart disease. 14) After cognitive behavioral therapy, these patients are reported to become active and perform tasks to modify negative thoughts and unhelpful behaviors and to decrease negative emotions.…”