Unraveling the impact of time-dependent perioperative variables on 30 day readmission following coronary artery bypass surgery
The Journal of Thoracic and Cardiovascular Surgery Oct 02, 2020
Manyam R, Zhang Y, Carter S, et al. - In healthcare, readmission within 30 days of discharge following coronary artery bypass grafting (CABG) determines quality as well as drives the cost. In this study, researchers generated a new model using both time-independent and time-dependent pre- and perioperative data that may aid in predicting time to readmission after CABG. They included adults surviving to discharge after isolated CABG at a multi-hospital academic health system and used two distinct data sources: the institutional cardiac surgical database, and the clinical data warehouse, to obtain more granular data points for each patient. The model was trained with 21 variables and scored a p-value of < 0.05 in the univariable analysis. Sixteen significant risk factors were identified with the multivariable model; of these, 6 were time-dependent, including preoperative hemoglobin a1c level, preoperative creatinine, preoperative hematocrit, intraoperative hemoglobin, postoperative creatinine, and postoperative hemoglobin. Observations revealed better predictive ability of a readmission model due to incorporation of time-dependent perioperative variables in an isolated CABG cohort. The inclusion of time-dependent covariates in the predictive model for readmission after discharge following CABG makes this study unique.
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