Chan Jeremy, Narayan Pradeep, Dong Tim, Fudulu Daniel P, Angelini Gianni D
Department of Cardiac Surgery, Bristol Heart Institute, University of Bristol, Bristol, United Kingdom.
JTCVS Open. 2025 Feb 10;24:239-255. doi: 10.1016/j.xjon.2025.02.001. eCollection 2025 Apr.
To evaluate hospital readmission rates in the United Kingdom within the first 12 months following heart valve surgery.
All patients who underwent heart valve surgery between January 2013 and April 2023 were included in the study. Readmission to any National Health Service hospital within 12 months after discharge was captured. Trends in readmission, primary and secondary diagnoses, and related procedures were evaluated.
A total of 44,467 patients (median age, 69.3 years; 61% male) were included, of whom 44.6%, 23.15%, and 11.95% experienced 1, 2, and 3 readmissions, respectively, within 12 months of discharge following the index procedure. The overall 30-day and 12-month readmission rates were 12.9% and 44.6%, respectively, with a total of 42,151 readmissions. The median time from discharge to readmission was 61 days (interquartile range, 14-168 days). The overall 12-month readmission rate remained consistently above 40% throughout the study period, with a slight drop in 2020 during the COVID-19 pandemic. Cardiovascular-related readmissions accounted for 10,318 (24.5%) of the total readmissions. Arrhythmia was the most common primary diagnosis (37.6%; atrial fibrillation/flutter in 82.4% of the cases), followed by heart failure (16.1%) and valve-related dysfunction (15.2%). Surgical valve procedure-related readmissions accounted for 24.9% of the total, with chest pain of noncardiac origin (41.0%), respiratory tract infections (16.0%), and pleural effusions (10.0%).
Nearly one-half of the patients required at least 1 readmission within 12 months of heart valve surgery, placing significant strain on the healthcare system. Cardiovascular- and procedure-related causes accounted for one-half of all readmissions.
评估英国心脏瓣膜手术后12个月内的医院再入院率。
纳入2013年1月至2023年4月期间接受心脏瓣膜手术的所有患者。记录出院后12个月内再次入住任何国民保健服务医院的情况。评估再入院趋势、主要和次要诊断以及相关手术。
共纳入44467例患者(中位年龄69.3岁;61%为男性),其中44.6%、23.15%和11.95%的患者在首次手术后出院的12个月内分别经历了1次、2次和3次再入院。30天和12个月的总体再入院率分别为12.9%和44.6%,共有42151次再入院。出院至再入院的中位时间为61天(四分位间距为14 - 168天)。在整个研究期间,12个月的总体再入院率一直保持在40%以上,在2020年新冠疫情期间略有下降。心血管相关再入院占总再入院次数的10318次(24.5%)。心律失常是最常见的主要诊断(37.6%;82.4%的病例为心房颤动/扑动),其次是心力衰竭(16.1%)和瓣膜相关功能障碍(15.2%)。手术瓣膜相关再入院占总数的24.9%,非心脏原因引起的胸痛(41.0%)、呼吸道感染(16.0%)和胸腔积液(10.0%)。
近一半的患者在心脏瓣膜手术后12个月内至少需要1次再入院,给医疗系统带来了巨大压力。心血管和手术相关原因占所有再入院次数的一半。