Educação Corporativa da Associação Beneficência Portuguesa de São Paulo, São Paulo, Brazil.
Programa de Pós-Graduação em Enfermagem, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil.
Braz J Cardiovasc Surg. 2020 Dec 1;35(6):884-890. doi: 10.21470/1678-9741-2020-0266.
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.
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.
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.
The predictors identified may support a closer postoperative follow-up and individualized planning for a safe discharge.
为了降低冠状动脉旁路移植术(CABG)后的再入院率,应在不同背景下了解其预测因素。本研究的目的是在巴西的一个中心确定 CABG 后 30 天内住院再入院的预测因素。
对接受单纯 CABG 的患者电子数据库进行二次分析。通过单因素分析研究 30 天内再入院与人口统计学、人体测量学、临床和手术相关特征之间的关系。通过多元逻辑回归确定预测因素。
共纳入 2272 例患者,再入院率为 8.6%。再入院的预测因素为棕色皮肤(Beta=1.613;95%置信区间[CI] 1.047-2.458;P=0.030)、非裔美国人种族(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)、术后使用血液制品(Beta=1.515;95%CI 1.101-2.086;P=0.011)、慢性阻塞性肺疾病(Beta=2.095;95%CI 1.284-3.419;P=0.003)和使用乙酰水杨酸(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)具有边缘显著意义。
确定的预测因素可能有助于进行更密切的术后随访和安全出院的个体化计划。