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Ann Thorac Surg 2003;75:68-73
© 2003 The Society of Thoracic Surgeons
a Division of Cardiothoracic Surgery, Temple, TX, USA
b Department of Biostatistics, Texas A & M University System Health Science Center, Scott and White Memorial Hospital, Temple, Texas, USA
* Address reprint requests to Dr Baisden, Division of Cardiothoracic Surgery, Scoot and White Memorial Hospital, 2401 South 31st St, Temple, TX 76508, USA
e-mail: cbaisden{at}swmail.sw.org
Presented at the Forty-eighth Annual Meeting of the Southern Thoracic Surgical Association, San Antonio, TX, Nov 8–10, 2001.
BACKGROUND: The fate of patients discharged the day following off-pump coronary bypass (OPCAB) has not previously been reported. We studied the mortality and readmissions of a consecutive series of patients discharged after OPCAB, and compared the outcomes of those discharged the day following surgery to the rest of the group.
METHODS: All patients having OPCAB through median sternotomy during the calendar year 2000 by a single surgeon were retrospectively reviewed. Demograghics, intraoperative variables and postoperative complications, readmissions and mortality were recorded. Factors were analyzed to determine associations with time of discharge and readmission.
RESULTS: One hundred fifteen patients had isolated OPCAB averaging 3.1 grafts. Two patients (1.8%) died before discharge. Sixty-three of 113 patients (55.8%) were discharged on day 1 and 8 (12.7%) required readmission compared to 13 of 50 (26%) discharged later. Diabetes (p = 0.04) and renal failure (p = 0.01) exhibited univariate association with day 1 discharge while multivariate analysis added infarction. The combination of previous bypass, obesity, acute myocardial infarction, and hypertension was associated with readmission in the entire OPCAB group but not in day 1 discharged patients.
CONCLUSIONS: The readmission rate for the entire group (18.6%) was high but lower in day 1 discharge patients (12.7%). Day 1 discharge (55.8%) was unusual in patients with diabetes, renal failure, or recent infarction. Previous bypass, obesity, acute myocardial infarction, and hypertension were associated with readmission for the entire group only. Day 1 discharged patients had no deaths or serious consequences, and there were no readmissions in more than 87%.
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