Preoperative Predictors of Hospital Readmission within 5 Years Following CABG: Cohort Analysis of the REPLICCAR II Database.

Abstract

Background: Reducing hospital readmissions following coronary artery bypass grafting (CABG) surgeries is essential to optimizing medium- and long-term patient outcomes.

Objective: To analyze preoperative predictors associated with all-cause and cardiac readmissions within 5 years following CABG.

Methods: We analyzed 1,387 patients who underwent CABG between June 2017 and July 2019 using data from the multicenter REPLICCAR II registry. Follow-up was carried out by telephone interviews using a questionnaire structured in the REDCap platform. Statistical analysis included univariate and multivariate methods, with Cox regression and internal validation through calibration and discrimination tests. A significance level of 5% was applied.

Results: The cumulative incidence of all-cause readmission was 27.69%, with a mean follow-up of 4.3 years and a mean time to readmission of 2.4 years. Multivariate regression analysis indicated the following predictors of higher all-cause readmission risk: lower body mass index (HR=0.97, p=0.032), history of myocardial infarction (HR=1.27, p=0.024), diabetes mellitus (HR=1.35, p=0.004), renal failure (HR=1.62, p=0.004), and higher STS score (HR=1.22, p<0.001). A moderate correlation was observed between readmission and mortality (Rho=0.55).

Conclusions: This analysis demonstrates that lower body mass index, history of myocardial infarction, diabetes mellitus, renal failure, and elevated STS scores are significant predictors of increased hospital readmission risk following CABG.