New Hospitalization Following Cardiovascular Surgery in Patients Assigned to a Plan of Optimal Discharge

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Abstract

Background

One of the principal objectives of every healthcare provider is to obtain an efficient control of costs and human resources without affecting the quality of care. Considering that in our institution the mean length of hospitalization following a CABG procedure is 11 days we designed the so called "optimal post-surgery discharge program".

Material and method

We selected 145/500 (29%) of patients admitted be tween March and September 1996 to the telemetry unit on first day following a cardiovascular surgical procedure (conventional or minimally invasive CABG, valve replacement or carotid endarterectomy). All of them were included in the optimal post-surgery discharge program wich limit hospital lenght of stay following the procedure to 1-5 days depending on the type of intervention. Re-hospitalization and all causes death rates were evaluated at 60 days after the procedure.

Results

The overall rehospitalization rate was 4.7% (3.4% cardiovascular causes, mainly supraventricular arrhythmias). No death were observed in this sub-group of patients. Discharge at day 4 post CABG was obtained in 78.3% of cases and 86.2% of post-valve replacement patients. Ninenty-one percent of patients that underwent a carotid endarterectomy was discharged on the post-operative day.

Conclusions

Readmission total rate was 4.7%. Cardiac surgery related new internation were 3.4% (mostly atrialf ibrillation) and 1.3% of non-cardiac causes (gastrointestinal bleeding and one greit hematoma following coronary angiogram).