gms | German Medical Science

128. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

03.05. - 06.05.2011, München

Readmission to intensive care unit after cardiac surgery – Analysis of 5,983 patients

Meeting Abstract

  • Sems Tugtekin - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Dominik Joskowiak - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Utz Kappert - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Anna Rudolph - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Christian Georgi - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Klaus Matschke - Herzzentrum Dresden, Herzchirurgie, Dresden

Deutsche Gesellschaft für Chirurgie. 128. Kongress der Deutschen Gesellschaft für Chirurgie. München, 03.-06.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgch711

DOI: 10.3205/11dgch711, URN: urn:nbn:de:0183-11dgch7119

Veröffentlicht: 20. Mai 2011

© 2011 Tugtekin et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: Readmission to the intensive care unit (ICU) after cardiac surgery is associated with higher costs and impaired clinical outcome. Clinical data and outcome of readmitted patients were analyzed and perioperative prognostic variables of ICU readmission evaluated.

Materials and methods: 5,983 patients who underwent CABG and/or valve or aortic surgery between 2007 and 2009 were reviewed retrospectively. The reasons for readmission and the postoperative course were analyzed. Furthermore, perioperative risk factors for readmission were determined by multivariate regression analysis.

Results: 5,983 patients were discharged from the ICU, 5.6% (335) of these patients required a second stay in the intensive care. The readmission rate was 3.6% following CABG and 7.8% following valve or aortic +/- CABG (p<0.0001). Of the patients who were not readmitted, 3.8% died in hospital, compared to 16.1% in group r (p<0.0001). After readmission, the mean length of stay in hospital was 26.1+/-5.9 days and 12.5+/-5.1 days for all other patients (p<0.05). Main reasons for readmission were respiratory failure (28%) and cardiovascular instability (32%), neurological complications (11%), sepsis (8%), bleeding (12%), abdominal(7%) and renal (7%). Multivariate logistic regression analysis revealed that preoperative renal insufficiency, pulmonary hypertension, reexploration for bleeding, postoperative renal failure and prolonged intubation were independent predictors for readmission.

Conclusion: Readmission to ICU is particular related with valve/combined surgery and associated with impaired outcome. Respiratory and cardiovascular complications were the most common reasons for readmission. Predictive renal and pulmonary risk factors indicate the particular need of preoperative preconditioning and patient selection.