ICU Readmission after Cardiac Surgery—Still a Matter of Concern?

Abstract

In conclusion, readmission to the ICU after cardiac surgery is a rare complication that is still associated with excessive mortality. Establishment of an intermediate care unit proved to be an excellent means to reduce ICU stay without endangering post-surgery patients and significantly reduced the ICU readmission rate.

Perioperative Risk Factors for Intensive Care Unit Readmissions and Mortality After Cardiac Surgery

“…Readmission to the ICU remains a serious concern, as it is associated with high mortality 3,8 . In this study, we reviewed a large and heterogeneous cohort of cardiosurgical patients to identify risk factors for ICU readmission and mortality.…”

“…In this study, we found that readmitted patients have a longer initial ICU stay than nonreadmitted patients (median 5 days vs. 3 days, p=0.01), further supporting the idea that an early ICU discharge is unlikely to be a cause for readmission. 2,3,5 However, others researchers oppose early ICU discharges. Based on a predictive model, Daly et al suggested that prolonging the ICU stay for another 48 hours may reduce the mortality of at-risk patients by 39%.…”

“…Despite improvements in perioperative care, the incidence of ICU readmission after cardiac surgery remains at 2-8%. [1][2][3][4][5] Strikingly, readmission is associated with in-hospital death rates as high as 11-24%, compared to 0.2-13% in non-readmitted patients. [1][2][3][4][5] Besides being associated with a poor prognosis for the patient, ICU readmissions also strain limited ICU resources.…”

“…Previous studies investigating risk factors for ICU readmission after cardiac surgery have reported disparate results. 3,4,6 Whether an extended initial stay in the ICU leads to better clinical outcomes is controversial. Although widely used and validated tools are lacking, recent analysis of preoperative factors was used to extrapolate a risk predicting tool for ICU readmissions.…”

Applicability of Clinical Decision Support in Management among Patients Undergoing Cardiac Surgery in Intensive Care Unit: A Systematic Review

“…In ICUs, physicians must control these parameters, care for subjects' needs, and prevent complications in order to achieve the optimal conditions of these patients. Therefore, professionals must make elaborate decisions in some situations and make modifications in treatment [15][16][17]. These situations cause high pressure and intense burden that can cause medical errors and may negatively influence patients' outcomes [18,19].…”