Kudret Atakan Tekin, Ahmet Can Topçu, Fatih Yiğit, Fatma İrem Öztürk, Taylan Adademir, Kaan Kırali
Early discharge following CABG does not independently increase the risk of 30-day readmission or emergency room presentation, and is a viable option. After risk adjustment, prolonged cardiopulmonary bypass time and surgical re-exploration were identified as independent predictors of 30-day readmission.
BACKGROUND: We aimed to evaluate the relationship between early discharge and 30-day readmission after isolated coronary artery bypass grafting (CABG).
METHODS: This retrospective study included all consecutive adults undergoing isolated CABG in a single tertiary institution between May 2023 and December 2024. Patients with concomitant cardiac procedures, in-hospital mortality, or prolonged hospitalization (>14 days) were excluded. Patients were categorized into early (≤5 days) and late (>5 days) discharge groups. The primary outcome was 30-day all-cause unplanned readmission. The secondary outcome was 30-day all-cause emergency room presentation.
RESULTS: The final cohort consisted of 1,470 patients. The rate of 30-day unplanned readmission was significantly lower in early discharge group compared to late discharge group (6.7% vs.12.0%, p = 0.001). In univariable analysis, advanced age, increased length of hospital stay, cardiopulmonary bypass time, mechanical ventilation duration, postoperative atrial fibrillation, and need for surgical re-exploration were significantly associated with an increased risk of hospital readmission. In multivariable analysis, early discharge was not an independent predictor of 30-day readmission (OR: 0.714, 95% CI: 0.470-1.085, p = 0.114). Multivariable analysis identified increased cardiopulmonary bypass time time (OR: 1.008, 95% CI: 1.003-1.013, p = 0.003) and surgical re-exploration (OR: 2.479, 95% CI: 1.283-4.788, p = 0.007) as independent predictors of 30-day readmission.
CONCLUSION: Early discharge following CABG does not independently increase the risk of 30-day readmission or emergency room presentation, and is a viable option. After risk adjustment, prolonged cardiopulmonary bypass time and surgical re-exploration were identified as independent predictors of 30-day readmission.