Hospital readmission in patients submitted to heart surgery: prospective cohort

Authors

DOI:

https://doi.org/10.33448/rsd-v9i7.4238

Keywords:

Perioperative Nursing; Cardiology; Patient Readmission; Thoracic Surgery; Quality of Health Care.

Abstract

Hospital readmissions are critical phenomena that delay the return of patients to their activities that maintain life, health and well-being. Objective:To assess the incidence and causes of readmission after hospital discharge in patients undergoing cardiac surgery. Method:Prospective observational study. The study included 181 patients who underwent cardiac surgery and were observed in the immediate preoperative periods and after hospital discharge on the 7th, 15th and 30th, through telephone contacts.Results:Of the 181 participants included in the study, 13 were discontinued due to intrahospital death and 1 due to transfer to another institution. Therefore, telephone contact was made with 167 patients, among whom 16 (9.58%) were readmitted. Of these, 2 were readmitted 7 days after hospital discharge; 7 were readmitted 15 days after discharge; and 7 readmitted 30 days after hospital discharge, with most readmissions due to infection of the surgical site in the mediastinum (18.75%) and saphenous vein (18.75%). Conclusion:Most readmissions were due to infection of the surgical site. This means that strategies to control and minimize these events should be part of the follow-up of cardiac surgery patients.

Author Biographies

Thalita Gomes do Carmo, Universidade Federal Fluminense

Doutora em ciências do cuidado em saúde. Professora da Universidade Federal Fluminense. Niterói - Rio de Janeiro, Brasil.

Rosimere Ferreira Santana, Universidade Federal Fluminense.

Pós-doutora em enfermagem. Professora da Universidade Federal Fluminense. Niterói - Rio de Janeiro, Brasil.

Marcos Venícius de Oliveira Lopes, Universidade Federal do Ceará

Pós-doutor em enfermagem. Professor da Universidade Federal do Ceará. Fortaleza – Ceará, Brasil. 

Uyara Garcia Melo, Hospital Sírio Libanês

Enfermeira. Residente no Centro Cirúrgico e CME do Hospital Sírio Libanês. São Paulo – São Paulo, Brasil.

Ana Beatriz Serra Hercules, Universidade Federal Fluminense

Enfermeira. Universidade Federal Fluminense. Niterói - Rio de Janeiro, Brasil.

Leonardo Secchin Canale, Hospital Universitário Antônio Pedro

Médico. Cirurgião Cardíaco em Hospital Universitário Antônio Pedro – Niterói – Rio de Janeiro, Brasil

References

Almeida, G.F., Vegni, R., Japiassú, A.M., Kurtz, P., Drumond, L.E., Freitas, M., Penna, G., Nobre, G. & Kalichzstein, M. (2011). Postoperative complications of surgically treated ascending aortic dissection. Rev Bras Ter Intensiva., 23(3), 304-11. Doi: https://doi.org/10.1590/S0103-507X2011000300008

Barreiros, B.R.N., Bianchi, E.R.F., Turrini, R.N.T., & Poveda, V.B. (2016). Causas de readmissão hospitalar após cirurgia cardíaca. Rev eletrônica enferm, 18, e1182. doi: http://dx.doi.org/10.5216/ree.v18.39529

Benuzillo, J., Caine, W., Evans, R.S., Roberts, C., Lappe, D. & Doty J. (2018). Predicting readmission risk shortly after admission for CABG surgery. J Card Surg., 33(4), 163–70. Doi: http://doi.wiley.com/10.1111/jocs.13565

Borges, M.F. & Turrini, R.N.T. (2011). Readmissions In Emergency Service: Morbidity Profile Of The Patients. Rev RENE, 12(3), 453-61.

Brasil. (2014). Instituto Nacional de Cardiologia. Recuperado em 07 janeiro, 2019, de: www.inc.saude.gov.br

Brasil. Agência Nacional de Vigilância Sanitária Medidas de Prevenção de Infecção Relacionada à Assistência à Saúde. Brasília: Anvisa, 2017. Recuperado em 13 março, 2019, de: http://portal.anvisa.gov.br/documents/33852/3507912/Caderno+4+-+Medidas+de+Prevenção+de+Infecção+Relacionada+à+Assistência+à+Saúde/a3f23dfb-2c54-4e64-881c-fccf9220c373

Braz, N.D.J., Evangelista, S.D.S., Evangelista, S.S., Garbaccio, J.L. & Oliveira, A.C. (2018). Surgical site infection in patients submmited to cardiac surgeries: an epidemiological profile analysis. RECOM., (8), e1793. Doi: https://doi.org/10.19175/recom.v7i0.1793

Brown, J.R., Jacobs, J.P., Alam, S.S., Thiessen-Philbrook, H., Everett, A., Likosky, D.S., Lobdell, K., Wyler, M.C., Parker, D.M., Garg, A.X., Mackenzie, T., Jacobs, M.L. & Parikh, C.R. (2018). Utility of Biomarkers to Improve Prediction of Readmission or Mortality After Cardiac Surgery. Ann Thorac Surg., 106(5), 1294–301. Doi: https://doi.org/10.1016/j.athoracsur.2018.06.052

Cykert, S. (2012). Improving Care Transitions Means More Than Reducing Hospital Readmissions. N C Med J., 73(1), 31–3.

Hall, M.H., Esposito, R.A., Pekmezaris, R., Lesser, M., Moravick, D., Jahn, L., Blenderman, R., Akerman, M., Nouryan, C.N. & Hartman, A.R. (2014). Cardiac Surgery Nurse Practitioner Home Visits Prevent Coronary Artery Bypass Graft Readmissions. Ann Thorac Surg., 97(5), 1488–95. doi: http://dx.doi.org/10.1016/j.athoracsur.2013.12.049

Iribarne, A., Chang, H., Alexander, J.H., Gillinov, A.M., Moquete, E., Puskas, J.D., Bagiella, E., Acker, M.A., Mayer, M.L., Ferguson, T.B., Burks, S., Perrault, L.P., Welsh, S., Johnston, K.C., Murphy, M., DeRose, J.J., Neill, A., Dobrev, E., Baio, K.T., Taddei-Peters, W., Moskowitz, A.J. & O'Gara, P.T. (2014). Readmissions After Cardiac Surgery: Experience of the National Institutes of Health. Ann Thorac Surg., 98(4), 1274–80. Doi: https://doi.org/10.1016/j.athoracsur.2014.06.059

Kathy, G. National Aging Network. Department of Health and Human Services, 2011. Recuperado em 24 outubro, 2019, de http://www.thescanfoundation.org/sites/default/files/ltc_fundamental_6.pdf

Lazar, E.J., Fleischut, P. & Regan, B.K. (2013). Quality Measurement in Healthcare. Annu Rev Med., 64(1), 485–96. Doi: https://doi.org/10.1146/annurev-med-061511-135544

Lee, J. (2017). Transitional care intervention: A readmission solution. Nurs Manag., 48(3), 32–9. Doi: https://doi.org/10.1097/01.NUMA.0000512507.39701.16

Lepelletier, D., Bourigault, C., Roussel, J.C., Lasserre, C., Leclère, B., Corvec, S., Pattier, S., Lepoivre, T., Baron, O. & Despins, P. (2013). Epidemiology and prevention of surgical site infections after cardiac surgery. Méd Mal Infect., 43(10), 403–9. Doi: https://doi.org/10.1016/j.medmal.2013.07.003

Li, Z., Amstrong, E.J., Parker, J.P., Danielsen, B. & Romano, P.S. (2012). Hospital Variation in Readmission After Coronary Artery Bypass Surgery in California. Circ Cardiovasc Qual Outcomes., 5(5), 729–37. doi: https://doi.org/10.1161/CIRCOUTCOMES.112.966945

Mata, L.R.F., Silva. A.C., Pereira, M.G. & Carvalho, E.C. (2014). Telephone follow-up of patients after radical prostatectomy: a systematic review. Rev Lat Am Enferm., 22(2), 337–45. Doi: https://doi.org/10.1590/0104-1169.3314.2421

Naughton, C., Bennett, K. & Feely, J. (2006). Prevalence of chronic disease in the elderly based on a national pharmacy claims database. Age Ageing, 35(6), 633–6. Doi: http://dx.doi.org/10.1093/ageing/afl106

Peikes, D., Lester, R.S., Gilman, B. & Brown, R. (2012). The Effects of Transitional Care Models On Re-Admissions: A Review of the Current Evidence. Generations., 36(4), 44–55. Recuperado em 13 março, 2019, de: https://www.ingentaconnect.com/content/asag/gen/2012/00000036/00000004/art00007

Ricci, H., Araújo, M.N. & Simonetti, S.H. (2017). Early readmission in a high complexity public hospital in cardiology. Rev da Rede Enferm do Nord., 17(6), 828-34. Doi: https://doi.org/10.15253/2175-6783.2016000600014

Smilowitz, N.R., Beckman, J.A., Sherman, S.E. & Berger, J.S. (2018) Hospital Readmission After Perioperative Acute Myocardial Infarction Associated With Noncardiac Surgery. Circulation., 137(22), 2332-39. doi: https://doi.org/10.1161/CIRCULATIONAHA.117.032086

Tsai, T.C., Joynt, K.E., Orav, E.J., Gawande, A. & Jha, A.K. (2013). Variation in Surgical-Readmission Rates and Quality of Hospital Care. N Engl J Med., 369(12), 1134–42. Doi: https://doi.org/10.1056/NEJMsa1303118

Vest, J.R., Gamm, L.D., Oxford, B.A., Gonzalez, M.I. & Slawson, K.M. (2010). Determinants of preventable readmissions in the United States: a systematic review. Implement Sci., 5(1), 88. Doi: http://dx.doi.org/10.1186/1748-5908-5-88

Published

20/05/2020

How to Cite

CARMO, T. G. do; SANTANA, R. F.; LOPES, M. V. de O.; MELO, U. G.; HERCULES, A. B. S.; CANALE, L. S. Hospital readmission in patients submitted to heart surgery: prospective cohort. Research, Society and Development, [S. l.], v. 9, n. 7, p. e419974238, 2020. DOI: 10.33448/rsd-v9i7.4238. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/4238. Acesso em: 29 apr. 2024.

Issue

Section

Health Sciences