Causes of readmission after operation for congenital heart disease

Sunil Saharan, Arthur T. Legg, Laurie Armsby, M. Mujeeb Zubair, Richard Reed, Stephen M. Langley

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background. Readmission after operations for congenital heart conditions has significant implications for patient care. Readmission rates vary between 8.7% and 15%. The aim of this study was to determine the incidence, causes, and risk factors associated with readmission. Methods. 811 consecutive patients undergoing operations for congenital heart conditions were analyzed. Readmission was defined as admission to any hospital within 30 days of discharge for any cause. Demographic, preoperative, operative, and postoperative variables were evaluated. Univariate comparisons were made between the nonreadmission and readmission groups, and multivariate logistic regression analysis was made to determine independent risk factors for readmission. Results. There were a total of 92 readmissions in 79 patients (9.7%). The reasons included cardiac (36, 39%), pulmonary (20, 22%), gastrointestinal (13, 14%), infectious (20, 22%), and other adverse events (2, 2%). Patients with either single-ventricle palliation or nasogastric feeding accounted for 40 (50%) readmissions. On univariate analysis, there were significant differences between readmitted and nonreadmitted patients in relation to patient age, chromosomal abnormality, mortality risk score, duration of mechanical ventilation, postoperative length of stay, single-ventricle physiology, and nasogastric feeding at discharge (p <0.05). On multivariate analysis, significant risk factors for readmission were single-ventricle physiology (odds ratio [OR] 2.39; 95% confidence interval [CI] 1.28 to 4.47; p = 0.005), preoperative arrhythmia (OR 2.59; 95% CI 1.02 to 6.59; p = 0.04), longer postoperative length of stay (OR 2.2; 95% CI 1.22 to 3.99; p = 0.008), and nasogastric tube feeding at discharge (OR 2.2; 95% CI 1.15 to 4.19; p = 0.01). Conclusions. The incidence of readmission after operations for congenital cardiac conditions remains high. Efforts focusing on patients with single-ventricle palliation and those with preoperative arrhythmia, prolonged postoperative length of stay and nasogastric tube feeding at discharge may be particularly beneficial.

Original languageEnglish (US)
Pages (from-to)1667-1673
Number of pages7
JournalAnnals of Thoracic Surgery
Volume98
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Heart Diseases
Odds Ratio
Confidence Intervals
Length of Stay
Enteral Nutrition
Cardiac Arrhythmias
Incidence
Artificial Respiration
Chromosome Aberrations
Patient Care
Multivariate Analysis
Logistic Models
Regression Analysis
Demography
Lung
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Causes of readmission after operation for congenital heart disease. / Saharan, Sunil; Legg, Arthur T.; Armsby, Laurie; Zubair, M. Mujeeb; Reed, Richard; Langley, Stephen M.

In: Annals of Thoracic Surgery, Vol. 98, No. 5, 2014, p. 1667-1673.

Research output: Contribution to journalArticle

Saharan, Sunil ; Legg, Arthur T. ; Armsby, Laurie ; Zubair, M. Mujeeb ; Reed, Richard ; Langley, Stephen M. / Causes of readmission after operation for congenital heart disease. In: Annals of Thoracic Surgery. 2014 ; Vol. 98, No. 5. pp. 1667-1673.
@article{fccbfa32cb4f4a93b2911a3fff179b78,
title = "Causes of readmission after operation for congenital heart disease",
abstract = "Background. Readmission after operations for congenital heart conditions has significant implications for patient care. Readmission rates vary between 8.7{\%} and 15{\%}. The aim of this study was to determine the incidence, causes, and risk factors associated with readmission. Methods. 811 consecutive patients undergoing operations for congenital heart conditions were analyzed. Readmission was defined as admission to any hospital within 30 days of discharge for any cause. Demographic, preoperative, operative, and postoperative variables were evaluated. Univariate comparisons were made between the nonreadmission and readmission groups, and multivariate logistic regression analysis was made to determine independent risk factors for readmission. Results. There were a total of 92 readmissions in 79 patients (9.7{\%}). The reasons included cardiac (36, 39{\%}), pulmonary (20, 22{\%}), gastrointestinal (13, 14{\%}), infectious (20, 22{\%}), and other adverse events (2, 2{\%}). Patients with either single-ventricle palliation or nasogastric feeding accounted for 40 (50{\%}) readmissions. On univariate analysis, there were significant differences between readmitted and nonreadmitted patients in relation to patient age, chromosomal abnormality, mortality risk score, duration of mechanical ventilation, postoperative length of stay, single-ventricle physiology, and nasogastric feeding at discharge (p <0.05). On multivariate analysis, significant risk factors for readmission were single-ventricle physiology (odds ratio [OR] 2.39; 95{\%} confidence interval [CI] 1.28 to 4.47; p = 0.005), preoperative arrhythmia (OR 2.59; 95{\%} CI 1.02 to 6.59; p = 0.04), longer postoperative length of stay (OR 2.2; 95{\%} CI 1.22 to 3.99; p = 0.008), and nasogastric tube feeding at discharge (OR 2.2; 95{\%} CI 1.15 to 4.19; p = 0.01). Conclusions. The incidence of readmission after operations for congenital cardiac conditions remains high. Efforts focusing on patients with single-ventricle palliation and those with preoperative arrhythmia, prolonged postoperative length of stay and nasogastric tube feeding at discharge may be particularly beneficial.",
author = "Sunil Saharan and Legg, {Arthur T.} and Laurie Armsby and Zubair, {M. Mujeeb} and Richard Reed and Langley, {Stephen M.}",
year = "2014",
doi = "10.1016/j.athoracsur.2014.05.043",
language = "English (US)",
volume = "98",
pages = "1667--1673",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "5",

}

TY - JOUR

T1 - Causes of readmission after operation for congenital heart disease

AU - Saharan, Sunil

AU - Legg, Arthur T.

AU - Armsby, Laurie

AU - Zubair, M. Mujeeb

AU - Reed, Richard

AU - Langley, Stephen M.

PY - 2014

Y1 - 2014

N2 - Background. Readmission after operations for congenital heart conditions has significant implications for patient care. Readmission rates vary between 8.7% and 15%. The aim of this study was to determine the incidence, causes, and risk factors associated with readmission. Methods. 811 consecutive patients undergoing operations for congenital heart conditions were analyzed. Readmission was defined as admission to any hospital within 30 days of discharge for any cause. Demographic, preoperative, operative, and postoperative variables were evaluated. Univariate comparisons were made between the nonreadmission and readmission groups, and multivariate logistic regression analysis was made to determine independent risk factors for readmission. Results. There were a total of 92 readmissions in 79 patients (9.7%). The reasons included cardiac (36, 39%), pulmonary (20, 22%), gastrointestinal (13, 14%), infectious (20, 22%), and other adverse events (2, 2%). Patients with either single-ventricle palliation or nasogastric feeding accounted for 40 (50%) readmissions. On univariate analysis, there were significant differences between readmitted and nonreadmitted patients in relation to patient age, chromosomal abnormality, mortality risk score, duration of mechanical ventilation, postoperative length of stay, single-ventricle physiology, and nasogastric feeding at discharge (p <0.05). On multivariate analysis, significant risk factors for readmission were single-ventricle physiology (odds ratio [OR] 2.39; 95% confidence interval [CI] 1.28 to 4.47; p = 0.005), preoperative arrhythmia (OR 2.59; 95% CI 1.02 to 6.59; p = 0.04), longer postoperative length of stay (OR 2.2; 95% CI 1.22 to 3.99; p = 0.008), and nasogastric tube feeding at discharge (OR 2.2; 95% CI 1.15 to 4.19; p = 0.01). Conclusions. The incidence of readmission after operations for congenital cardiac conditions remains high. Efforts focusing on patients with single-ventricle palliation and those with preoperative arrhythmia, prolonged postoperative length of stay and nasogastric tube feeding at discharge may be particularly beneficial.

AB - Background. Readmission after operations for congenital heart conditions has significant implications for patient care. Readmission rates vary between 8.7% and 15%. The aim of this study was to determine the incidence, causes, and risk factors associated with readmission. Methods. 811 consecutive patients undergoing operations for congenital heart conditions were analyzed. Readmission was defined as admission to any hospital within 30 days of discharge for any cause. Demographic, preoperative, operative, and postoperative variables were evaluated. Univariate comparisons were made between the nonreadmission and readmission groups, and multivariate logistic regression analysis was made to determine independent risk factors for readmission. Results. There were a total of 92 readmissions in 79 patients (9.7%). The reasons included cardiac (36, 39%), pulmonary (20, 22%), gastrointestinal (13, 14%), infectious (20, 22%), and other adverse events (2, 2%). Patients with either single-ventricle palliation or nasogastric feeding accounted for 40 (50%) readmissions. On univariate analysis, there were significant differences between readmitted and nonreadmitted patients in relation to patient age, chromosomal abnormality, mortality risk score, duration of mechanical ventilation, postoperative length of stay, single-ventricle physiology, and nasogastric feeding at discharge (p <0.05). On multivariate analysis, significant risk factors for readmission were single-ventricle physiology (odds ratio [OR] 2.39; 95% confidence interval [CI] 1.28 to 4.47; p = 0.005), preoperative arrhythmia (OR 2.59; 95% CI 1.02 to 6.59; p = 0.04), longer postoperative length of stay (OR 2.2; 95% CI 1.22 to 3.99; p = 0.008), and nasogastric tube feeding at discharge (OR 2.2; 95% CI 1.15 to 4.19; p = 0.01). Conclusions. The incidence of readmission after operations for congenital cardiac conditions remains high. Efforts focusing on patients with single-ventricle palliation and those with preoperative arrhythmia, prolonged postoperative length of stay and nasogastric tube feeding at discharge may be particularly beneficial.

UR - http://www.scopus.com/inward/record.url?scp=84922419066&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922419066&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2014.05.043

DO - 10.1016/j.athoracsur.2014.05.043

M3 - Article

VL - 98

SP - 1667

EP - 1673

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 5

ER -