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心房颤动患者心脏直视手术后30天再入院风险的回顾性研究

A Retrospective Review of 30-Day Hospital Readmission Risk After Open Heart Surgery in Patients With Atrial Fibrillation.

作者信息

Rao Varun, DeLeon Genaro, Thamba Aish, Flanagan Mindy, Nickel Kathleen, Gerue Michael, Gray Douglas

机构信息

Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, USA.

Department of General Surgery, Indiana University School of Medicine, Indianapolis, USA.

出版信息

Cureus. 2023 Sep 22;15(9):e45755. doi: 10.7759/cureus.45755. eCollection 2023 Sep.

Abstract

Introduction Readmission rates after open heart surgery (OHS) remain an important clinical issue. The causes are varied, with identifying risk factors potentially providing valuable information to reduce healthcare costs and the rate of post-operative complications. This study aimed to characterize the reasons for 30-day hospital readmission rates of patients after open heart surgery. Methods All patients over 18 years of age undergoing OHS at a community hospital from January 2020 through December 2020 were identified. Demographic data, medical history, operative reports, post-operative complications, and telehealth interventions were obtained through chart review. Descriptive statistics and readmission rates were calculated, along with a logistic regression model, to understand the effects of medical history on readmission. Results A total of 357 OHS patients met the inclusion criteria for the study. Within the population, 8.68% of patients experienced readmission, 10.08% had an emergency department (ED) visit, and 95.80% had an outpatient office visit. A history of atrial fibrillation (AFib) significantly predicted 30-day hospital readmissions but not ED or outpatient office visits. Telehealth education was delivered to 66.11% of patients. Conclusion The study investigated factors associated with 30-day readmission following OHS. AFib patients were more likely to be readmitted than patients without atrial fibrillation. No other predictors of readmission, ED visits, or outpatient office visits were found. Patients reporting symptoms of tachycardia, pain, dyspnea, or "other" could be at increased risk for readmission.

摘要

引言 心脏直视手术(OHS)后的再入院率仍然是一个重要的临床问题。其原因多种多样,识别风险因素可能会提供有价值的信息,以降低医疗成本和术后并发症发生率。本研究旨在描述心脏直视手术后患者30天内再次入院的原因。方法 确定了2020年1月至2020年12月期间在一家社区医院接受心脏直视手术的所有18岁以上患者。通过病历审查获取人口统计学数据、病史、手术报告、术后并发症和远程医疗干预措施。计算描述性统计数据和再入院率,并建立逻辑回归模型,以了解病史对再入院的影响。结果 共有357例心脏直视手术患者符合该研究的纳入标准。在该人群中,8.68%的患者再次入院,10.08%的患者前往急诊科就诊,95.80%的患者进行门诊就诊。房颤病史显著预测了30天内再次入院,但对急诊科或门诊就诊无显著影响。66.11%的患者接受了远程医疗教育。结论 本研究调查了与心脏直视手术后30天再入院相关的因素。房颤患者比无房颤患者更易再次入院。未发现其他再入院、急诊科就诊或门诊就诊的预测因素。报告心动过速、疼痛、呼吸困难或“其他”症状的患者再入院风险可能增加。

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