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

Holaubek, Caroline; Winter, Fabian; Lesjak, Anita; Aliabadi-Zuckermann, Arezu; Opfermann, Philipp; Urbanek, B; Schlömmer, Christine; Mouhieddine, M.; Zuckermann, Andreas; Steinlechner, Barbara

doi:10.1053/j.jvca.2021.10.044

Cited by 7 publications

(11 citation statements)

References 20 publications

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“…The incidence of ICU readmission in cardiac surgical patients within the course of the index hospitalization ranges from 2 to 8% based on the existing relevant literature. 4 5 6 7 8 9 10 11 12 13 14 15 ICU readmission entails a protracted length of stay in the hospital and consequent unfavorable clinical outcomes. The in-hospital mortality rates are to the remarkable tune of 11 to 24% for the readmitted patient cohort.…”

Section: Readmission As An Event Is “ Far From Benign”mentioning

confidence: 99%

“…The in-hospital mortality rates are to the remarkable tune of 11 to 24% for the readmitted patient cohort. 4 There are studies to suggest as much as six times escalation in mortality rates and, three to seven times the increase in the length of hospital stay and the length of ICU stay, respectively, in the readmitted patients, in contrast to the nonreadmitted patients. 7 8 The former negatively impacts the morale of the entire perioperative team and more importantly, the resolute of the primary patient caregivers.…”

Section: Readmission As An Event Is “ Far From Benign”mentioning

confidence: 99%

“…Moreover, the resultant strain imposed on the health care system can also not be ignored, particularly in the context of an increased cost and resource burden on the already constrained ecosystem of the low- and middle-income countries. 4 5 7 8 9 10 11 12 13 14 15 Bettex and Rudiger adequately elaborate the negative impact of readmission not only on the health system but the family of the patient as well. 7…”

Section: Readmission As An Event Is “ Far From Benign”mentioning

confidence: 99%

“…The causes for ICU readmission in cardiac surgical subset outlined by the various independent research groups have been summarized in Table 1 . 4 5 6 7 8 9 10 11 12 13 14 15 The majority of the ICU readmissions result owing to the underlying respiratory and cardiac reasons. Postoperative pneumonia (hospital-acquired/aspiration), pleural–effusion, poor ventilatory reserve, etc., leading to hypoxemia and respiratory failure necessitating reintubation and mechanical ventilation, account for the major cause of readmission.…”

Section: Icu Readmission: Causes and Risk Factorsmentioning

confidence: 99%

“…1 2 3 As we embrace the ever-growing opportunities to fast-track following cardiac surgery, there is a concurrent need to holistically assess the research landscape of a closely related and equally (if, not more) important phenomenon of intensive care unit (ICU) readmission in cardiac surgical subset following a primary discharge. 4 5 6 7 8 9 10 11 12 13 14 15…”

Section: Introductionmentioning

confidence: 99%

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ICU Readmission in Cardiac Surgical Subset: A Problem Worth Pondering

Kalaiselvan

Kashav

Kohli

et al. 2022

Journal of Cardiac Critical Care TSS

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Over the past decades, there have been noteworthy advancements in the cardiac surgical practice that have assisted fast-tracking and enhanced recovery after cardiac surgery (ERACS). With that said, intensive care unit (ICU) readmission in this high-risk patient cohort entails a significant morbidity–mortality burden. As an extension of the same, there has been a heightened emphasis on a comprehensive evaluation of the predisposition to readmission following a primary ICU discharge. However, the variability of the institutional perioperative practices and the research complexities compound our understanding of this heterogeneous outcome of readmission, which is intricately linked to both patient and organizational factors. Moreover, a discussion on ICU readmission in the recent times can only be rendered comprehensive when staged in close conjunction to the fast-tracking practices in cardiac surgery. From a more positive probing of the matter, a preventative outlook can likely mitigate a part of the larger problem of ICU readmission. Herein, focused cardiac prehabilitation programs can play a potential role given the emerging literature on the positive impact of the former on the most relevant readmission causes. Therefore, the index review article aims to address the subject of cardiac surgical ICU readmission, highlighting the magnitude and burden, the causes and risk-factors, and the research complexities alongside deliberating the topic in the present-day context of ERACS and cardiac prehabilitation.

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