Effect of early, individualised and intensified follow-up after open heart valve surgery on unplanned cardiac hospital readmissions and all-cause mortality

Borregaard, Britt; Dahl, Jordi S.; Riber, Lars Peter; Ekholm, Ola; Sibilitz, Kirstine Lærum; Weiss, M; Sørensen, Jan; Berg, Selina Kikkenborg; Møller, Jacob Eifer

doi:10.1016/j.ijcard.2019.02.056

Cited by 21 publications

(38 citation statements)

References 20 publications

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“…In this retrospective cohort study, 25% of all patients undergoing open‐heart valve surgery experienced unplanned, cardiac readmission within 30 days and 37% within 180 days after discharge. These numbers correspond to similar studies reporting readmission rates up to 27% within 30 days after discharge, indicating high readmission rates after open‐heart valve surgery in general 1,4,15 . Similarly, others have found readmission rates up to 43% at 180‐days after discharge and 56% within the first year 1,2,5 …”

Section: Discussionsupporting

confidence: 88%

“…Prediction of readmission of any kind is difficult, involving a variety of factors, both quantifiable and nonquantifiable, including the likelihood of the patient seeking medical attention and the willingness of the admitting physician to readmit the patient to the hospital. However, in a recent prospective cohort study, conducted by the same research group as of the current paper, it has been demonstrated how it is possible to reduce readmission rates after open‐heart valve surgery by early, intensified follow‐up after discharge 15 . However, more research investigating similar interventions is needed to design the appropriate monitoring after valve surgery.…”

Section: Discussionmentioning

confidence: 80%

“…These numbers correspond to similar studies reporting readmission rates up to 27% within 30 days after discharge, indicating high readmission rates after open-heart valve surgery in general. 1,4,15 Similarly, others have found readmission rates up to 43% at 180-days after discharge and 56% within the first year. 1,2,5 The causes of readmission were similar to other studies, although the readmission rates due to atrial fibrillation/flutter and heart failure were lower than previously reported.…”

Section: Discussionmentioning

confidence: 83%

“…Second, the study was conducted as a single‐center study which might influence generalizability, although most results concur with previous findings. Third, data in this cohort has previously been used to define a control group in a propensity‐matched study, 15 in which, patients who received follow‐up due to infective endocarditis and debilitation perioperative stroke were excluded, so these data were not available.…”

Section: Discussionmentioning

confidence: 99%

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Causes and characteristics associated with early and late readmission after open‐heart valve surgery

et al. 2020

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Objectives The objectives of the study were to describe the causes of readmission from discharge to 30 days and from day 31 to 180 after discharge and to investigate the characteristics associated with overall and cause‐specific readmissions after open‐heart valve surgery. Methods A single‐center, retrospective cohort of 980 patients undergoing open‐heart valve surgery from 2013 to 2016. Time to the first readmission was analyzed using univariable and multivariable Cox proportional hazard models. Results are reported as hazard ratios (HR) with 95% confidence intervals (CI). Results In total, 366 patients (37%) experienced unplanned cardiac readmission within 180 days after discharge. Within 30 days after discharge, the most frequent causes of readmission were pericardial/pleural effusions (n = 87), infections (n = 50), and atrial fibrillation/flutter (n = 45). Accordingly, infections (n = 32) were the most common cause from day 31 to 180. No powerful predictors of overall cardiac readmission were identified, but several characteristics were associated with cause‐specific readmissions: age ≤65 years (HR: 1.85; CI: 1.18‐2.88), male gender (HR: 1.85; CI: 1.11‐3.09), high alcohol intake (HR: 1.99; CI: 1.22‐3.24) and mitral valve procedures (HR: 1.86; CI: 1.11‐3.10) were associated with readmissions due to effusions. Ischemic heart disease with a prior percutaneous coronary intervention (HR: 2.94; CI: 1.53‐5.63), mitral valve procedures (HR: 2.10; CI: 1.23‐3.59), and postoperative atrial fibrillation/flutter (HR: 1.71; CI: 1.03‐2.85) were associated with atrial fibrillation/flutter readmissions. Conclusion Predicting overall readmissions after open‐heart valve surgery is difficult as causes of readmissions vary and different causes are associated with different characteristics. Future studies should target reducing cause‐specific readmissions.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Causes and characteristics associated with early and late readmission after open‐heart valve surgery

et al. 2020

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“…clinical outcomes and which imposes high costs on both patients and the healthcare system 10 as reflected by long hospital stays and more readmissions. 11 In a new movement to decrease healthcare costs, much attention has been focused on the rate of readmission during the first 30 days after discharge from hospital.…”

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The Relationship Between Performance Indicators and Readmission of Patients With Open Heart Surgery: A Case Study in Iran

et al. 2019

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Background: Open heart surgery is a prevalent therapeutic intervention for cardiovascular diseases. Significant adverse effects occur after heart surgery, one of which is patient readmission to the hospital. Objective: The present study aimed to determine the relationship between performance indicators and the readmission of patients with open heart surgery in a teaching hospital in Iran. Methods: This study was performed using a cross-sectional and descriptive method with a retrospective approach. Data was collected on a data collection form. The statistical population of this study comprised all patients who underwent open heart surgery from mid-September 2015 to mid-September 2016 in a teaching hospital in the north of Iran (n=849). Those patients readmitted to the hospital within 90 days after discharge, based on a review of patient records, were included in the study. Descriptive statistics and Spearman correlation coefficient were used for data analysis by SPSS 20. Results: Among the patients who had open heart surgery in the selected hospital, 12.5% were readmitted within 90 days after discharge. The most important reasons for readmission in this study were infection in surgery place (25.8%), pleural effusion (18.7%), warfarin toxicity (9.8%), and tamponade (8.9%). There were inverse relationships between patient readmission and the two performance indicators of bed occupancy percentage (r = -0.594, P=0.042) and bed turnover rate (r = -0.664, P=0.018). There were no statistically significant relationships between any of the other indicators (length of stay, mortality, and bed turnover interval) and readmission rate (P>0.1). Conclusion: Hospital authorities can use these results for bed management and targeting interventions to reduce costs and readmissions as a measure of hospital quality. However, further research into readmission factors in other hospitals is recommended.

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Exercise-based cardiac rehabilitation for adults after heart valve surgery

Abraham

Sibilitz

Berg

et al. 2021

Cochrane Database of Systematic Reviews

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Effect of early, individualised and intensified follow-up after open heart valve surgery on unplanned cardiac hospital readmissions and all-cause mortality

Abstract: Effect of early, individualised and intensified follow-up after open heart valve surgery on unplanned cardiac hospital readmissions and all-cause mortality

Cited by 21 publications

References 20 publications

Causes and characteristics associated with early and late readmission after open‐heart valve surgery

Causes and characteristics associated with early and late readmission after open‐heart valve surgery

The Relationship Between Performance Indicators and Readmission of Patients With Open Heart Surgery: A Case Study in Iran

Exercise-based cardiac rehabilitation for adults after heart valve surgery

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