Readmission to the intensive care unit after "fast-track" cardiac surgery: Risk factors and outcomes

Alexander Kogan, Jonathan Cohen, Ehud Raanani, Gideon Sahar, Boris Orlov, Pierre Singer, Bernardo A. Vidne

Research output: Contribution to journalArticlepeer-review


Background. The introduction of "fast-track" management into cardiac surgery has significantly shortened the intensive care unit (ICU) length of stay. Readmission to the ICU, traditionally used as a quality index, has not been investigated in these patients. The aim of this study was to assess the causes, risk factors, and outcomes associated with readmission to the ICU. Methods. All patients undergoing open-heart surgery in a tertiary care, university-affiliated center were included in this prospective observational study. Preoperative and intraoperative data as well as ICU outcome were noted in all patients. Results. Over the 27-month study period,1,613 patients were targeted for fast track management (discharge from ICU on the first postoperative day). The readmission rate was 3.29% (53 patients). Forty-three percent of readmissions occurred within 24 hours of discharge usually because of pulmonary problems (43%) or arrythmias (13%). Readmission was associated with a prolonged ICU stay (105 ± 180.0 versus 19.2 ± 2.4 hours of initial ICU stay) and worse outcome: the only patients who died (6 of 53, 11.3%) were in this group. On multivariate analysis, a Bernstein-Parsonnet risk estimate more than 20 strongly predicted readmission (odds ratio, 3.08; 95% confidence interval, 1.43 to 6.69). Conclusions. Among a homogeneous group of patients targeted for fast-track management after cardiac surgery, readmission although uncommon is associated with a longer second ICU stay and significant mortality. The recognition of specific risk factors may allow for appropriate modification of the postoperative course.

Original languageEnglish
Pages (from-to)503-507
Number of pages5
JournalAnnals of Thoracic Surgery
Issue number2
StatePublished - 1 Aug 2003


Dive into the research topics of 'Readmission to the intensive care unit after "fast-track" cardiac surgery: Risk factors and outcomes'. Together they form a unique fingerprint.

Cite this