Risk factors for perioperative mortality after coronary artery bypass
graft (CABG) surgery have been extensively studied. However, which factors
are associated with early readmissions following CABG surgery are less clear.
To identify significant predictors of readmission within 30 days following
Design, Setting, and Patients
Causes for readmission within 30 days were investigated for all patients
discharged after CABG surgery in the state of New York from January 1, 1999,
through December 31, 1999. A variety of patient demographics, preoperative
risk factors, complications, operative and postoperative factors, and provider
characteristics were considered as potential predictors of readmissions.
Main Outcome Measure
Hospital readmissions within 30 days of discharge following CABG surgery.
Of 16 325 total patients, 2111 (12.9%) were readmitted within 30
days for reasons related to CABG surgery. The most common causes of readmission
were postsurgical infection (n = 598 [28%]) and heart failure (n = 331 [16%]).
Eleven risk factors were found to be independently associated with higher
readmission rates: older age, female sex, African American race, greater body
surface area, previous myocardial infarction within 1 week, and 6 comorbidities.
After controlling for these preoperative patient-level risk factors, 2 provider
characteristics (annual surgeon CABG volume <100, hospital risk-adjusted
mortality rate in the highest decile) and 2 postoperative factors (discharge
to nursing home or rehabilitation/acute care facility, length of stay during
index CABG admission of ≥5 days) were also related to higher readmission
Readmission within 30 days following discharge is an important adverse
outcome of CABG surgery. Continued attempts should be made to explore the
potential of readmission as a supplement to mortality in assessing provider