Objective: To evaluate the frequency, causes, and related predictive factors of intensive care unit (ICU) readmissions after coronary artery bypass grafting (CABG) surgery.
Methods: A total of 4112 consecutive patients who underwent on-pump CABG between January 2007 and January 2017 were retrospectively evaluated. The patients were divided into two groups as patients with and without ICU readmission. Demographic and perioperative characteristics were compared between the two groups.
Results: The ICU readmission rate was 3.5%. The most common reasons for ICU readmissions were respiratory (29%) and cardiac (23.4%) complications. The 90-day mortality risk was significantly higher in the readmitted patients than the non-readmitted patients (22.1% and 1.6%, respectively; P<0.001; OR=17.6; 95% CI=11.19-28.41). Severe left ventricular dysfunction, chronic obstructive pulmonary disease, end-stage renal disease, emergency CABG, EuroSCORE II > 5%, cross-clamp time > 35 minutes, postoperative respiratory complications, neurological complications, and cardiac complications showed a strong association with ICU readmissions.
Conclusion: ICU readmission after CABG is associated with an increased mortality rate. Evaluation, not only of patients' comorbidities, but also of intraoperative conditions and postoperative complications, is important to identify patients at risk for ICU readmission.
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http://dx.doi.org/10.21470/1678-9741-2019-0299 | DOI Listing |
Geroscience
January 2025
Department of Emergency Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
As the elderly population expands, enhancing emergency department (ED) care by assessing frailty becomes increasingly vital. To address this, we developed a novel electronic Frailty Index (eFI) from ED health records, specifically designed to assess frailty and predict hospitalization, in-hospital mortality, ICU admissions, and 30-day ED readmissions. This retrospective, single-center study included patients 65 years old or older who presented to the ED of IRCCS Humanitas Research Hospital in Milan, Italy, between January 2015 and December 2019.
View Article and Find Full Text PDFAust J Rural Health
February 2025
Doctoral Diploma of Medicine, Newcastle University, Callaghan, New South Wales, Australia.
Introduction: Research suggests a significant disparity between rural and urban trauma patient outcomes, causing substantial social, economic and emotional costs, impacting health-related quality of life and functionality, and straining our healthcare system. There has not been a systematic examination of contributing factors in Australia.
Objective: This study aims to systematically describe the nature of research on trauma outcomes by geographical location and (where possible) describe factors found to increase or decrease the likelihood and severity of injury in rural Australia.
Injury
January 2025
Brigham and Women's Hospital, Dpt. of Orthopaedic Surgery, Boston, MA, United States; Harvard Medical School Orthopedic Trauma Initiative, Boston, MA, United States.
Background: Older adults with rib fractures pose an increasing clinical and financial burden on healthcare. Identifying and addressing the increased risk of adverse outcomes has been a key objective in geriatric co-management of surgical patients. The Comprehensive Geriatric Assessment-based Frailty Index (FI-CGA) is a useful predictor of complications and mortality in older adults, but its value in rib fracture management remains unclear.
View Article and Find Full Text PDFAm J Emerg Med
January 2025
M.D., Professor, Kocaeli University, Faculty of Medicine, Dept. of Emergency Medicine, Kocaeli, Turkey.
Objectives: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) frequently result in emergency department (ED) visits, necessitating accurate risk stratification. The aim of this study was to evaluate and compare the prognostic utility of the DECAF score and serum procalcitonin levels in predicting clinical outcomes in patients with AECOPD.
Methods: This retrospective cohort study encompassed AECOPD patients presenting to the ED over a three-year period who had serum procalcitonin levels measured.
Med Care
February 2025
University of Pennsylvania School of Nursing, NewCourtland Center for Transitions and Health, Philadelphia, PA.
Objective: To examine the characteristics and risk factors associated with 30-day readmissions, including the impact of home health care (HHC), among older sepsis survivors transitioning from hospital to home.
Research Design: Retrospective cohort study of the Medical Information Mart for Intensive Care (MIMIC)-IV data (2008-2019), using generalized estimating equations (GEE) models adjusting for patient sociodemographic and clinical characteristics.
Subjects: Sepsis admission episodes with in-hospital stays, aged over 65, and discharged home with or without HHC were included.
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