The predictors and outcome of recidivism in cardiac ICUs

• DOI: 10.1016/j.ejcts.2004.11.016
• Publication Date: 2004-12-21T20:37:00Z
• Authors: H VOHRA; I GOLDSMITH; M ROSIN; N BRIFFA; R PATEL
• Keywords: Recidivism

Reinstitution of step-up care (recidivism) following cardiac surgery may be associated with increased mortality. This has, however, not been widely reported.We, therefore, studied 8113 consecutive patients who underwent coronary artery bypass grafting (CABG), valve replacement/repair or combined valve+CABG between January 1996 and December 2003 to determine the reasons for readmission intensive unit (ICU) their outcomes in terms length stay (i) ICU (ii) hospital (iii) in-hospital mortality recidivism.Of 7717 discharged out ICU, 2.3% (182) [mean age 70.4+/-8.35 years (range 30-90 years); 65.4% (119) males] required care. Recidivism was 1.8% (101 5633) by-pass (CABG) 3.9% (81 2084) replacement/repair+/-CABG (P<0.05). The mean interval from discharge recidivism 6.6+/-8.4 days 6h 28 days). principal were respiratory failure requiring reintubation ventilation 54.9% (n=100) cardiovascular instability (including that secondary dysrhythmias) heart 23.1% (n=42) renal haemofiltration 6.6% (n=12) (iv) sepsis 1.1% (n=2) (v) tamponade/bleeding re-exploration 7.7% (n=14) (vi) gastro-intestinal complications laparotomy 6.0% (n=11) patients. Multivariate analysis showed that, during primary stay, complications, low output state, dysrhythmias, bleeding independent predictors recidivism. Following 6.65+/-6.2 4h 51 days), 19.2+/-17.3 (10-60 days) 30-day 32.4%.Patients are more likely require surgery+/-CABG than CABG alone. Whilst most common our study, mechanical supports maintain vital functions prone Hence, efforts should made treat cardio-respiratory problems early this group reduce