Browse > Article
http://dx.doi.org/10.5392/JKCA.2022.22.02.794

Factor affecting Unplanned Readmissions after Cardiac Valve Surgery: Analysis of Electric Medical Record  

Lee, Jung Sun (한양대학교 대학원/서울아산병원)
Shin, Yong Soon (한양대학교 간호학부/간호과학연구소)
Publication Information
The Journal of the Korea Contents Association / v.22, no.2, 2022 , pp. 794-802 More about this Journal
Abstract
This retrospective study was to investigate the characteristics of unplanned readmission and factors affecting readmission within 30 days of discharge in patients who underwent heart valve surgery through electronic medical records. The participants were 423 unplanned re-hospitalization within 30 days after heart valve surgery at a tertiary hospital in Seoul from January 2018 to August 2019. A total of 48 patients (11.3%) were unplanned readmissions, and the most common causes were atrial fibrillation in 13 cases (27.1%) and pain at the surgical site in 13 cases (27.1%). Other causes were: 10 cases (20.8%) of warfarin inappropriate treatment concentration, 7 cases of general weakness (14.6%), 5 cases of hypotension (10.4%), 4 cases of pericardial effusion (8.3%), 3 cases of surgical wound infection (6.3%), 3 cases of hemorrhage (6.3%), 3 cases of high fever (6.3%), and 1 case of cerebral infarction (2.1%). Variables influencing readmission were history of cancer (OR = 2.60, 95% CI 1.13-6.03, p = .025) and the patients who went to a home rather than a hospital after discharge (OR = 2.91, 95% CI 1.33-6.36, p = .008), as a type of valve surgery, mitral valve valvuloplasty had a higher readmission rate than aortic valve replacement (OR = 1.21, 95% CI 1.21-4.98, p = .012). In order to reduce unplanned readmissions, an tailored education program is needed to enable patients and caregivers to manage their comorbid chronic diseases before discharge and assess risk factors for readmission in advance.
Keywords
Cardiac Surgery Procedures; Unplanned Readmission; Cancer Survivors; Patient Discharge; Education;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
연도 인용수 순위
1 M. S. Shin and W. J. Lee, "Estimation of cost by unnecessary readmission of the tertiary hospitals," J of the Korea Convergence Society, Vol.8, No.12, pp.149-157, 2017.   DOI
2 N. J. Goel, A. Iyengar, J. J. Kelly, C. R. Brown, F. Kurshan, P. Atluri, M. A. Acker, Z. Chen, and N. D. Desai, "Causes, risk factors, and costs of 30-Day readmissions after mitral valve repair and replacement," The Annals of Thoracic Surgery, Vol.108, No.6, pp.1729-1737, 2019.   DOI
3 S. S. Kim, "Analysis of variation of length of stay according to comorbidities in cancer inpatient," Journal of Health Informatics and Statistics, Vol.45, No.1, pp.80-90, 2020.   DOI
4 B. Borregaard, J. Sorensen, O. Ekholm, J. E. Moller, L. P. Riber, L. Thrysoee, C. B. Thorup, M. Vamosi, A. V. Christensen, T. B. Rasmussen, and S. K. Berg, "Sociodemographic, clinical and patient-reported outcomes and readmission after heart valve surgery," Journal of Heart Valve Disease, Vol.27, No.1, pp.78-86, 2018.
5 S. W. Cho, S. W. Cho, C. H. Chung, K. S. Kim, S. J. Choo, H. Song, M. G. Song, and J. W. Lee, "Initial experience of robotic cardiac surgery," Korean Journal of Thoracic and Cardiovascular Surgery, Vol.38, No.5, pp.366-370, 2005.
6 D. H. Kim and D. H. Kang, "Early surgery in valvular heart disease," Korean Circulation Journal, Vol.48, No.11, pp.964-973, 2018.   DOI
7 P. W. Park, "Rapidly increased elderly cardiac valve patient," Korea Health Industry Develop ment Institute, 2008. htttps://www.khidi.or.kr/board/view?linkId=132005&menuId=MENU00898
8 국민건강보험, 2017년 주요수술통계연보, 2018. https://www.nhis.or.kr/nhis/together/wbhaec068 00m01.do?mode=view&articleNo=128003
9 C. X. Hu, J. S. Tan, H. Chen, and Z. W. Xu, "Comparison of clinical outcomes and postoperative recovery between two open heart surgeries: minimally invasive right subaxillary vertical thoracotomy and traditional median sternotomy," Asian Pacific Journal of Tropical Medicine, Vol.7, No.8, pp.625-629, 2014.   DOI
10 H. A. Kim, A study on classifying reasons for hospital readmissions (master's thesis), Seoul: Yonsei University, 2004.
11 M. S. Kim, S. J Cho, S. J. Park, S. W. Cho, S. H. Choi, H. S. Kim, K. Carriere, E. K. Kim, S. A. Chang, S. C. Lee, and S. W. Park, "Frequency and clinical associating factors of valvular heart disease in asymptomatic korean adults," Scientific Reports, Vol.9, No.1, p.16741, 2019.   DOI
12 G. Marc, E. Jacob, S. Jordi, and R. Lars, "Causes and characteristics associated with early and late readmission after open-heart valve surgery," Journal of Cardiac Surgery, Vol.35, pp.747-754, 2020.   DOI
13 B. G. Lee, T. S. Lee, and S. H. Kim, "Mediation effect of self-efficacy on the relationship between perceived self-management support and health-related quality of life among cancer survivors," Journal of Korean Academy of Nursing, No.49, No.3, pp.298-306, 2019.   DOI
14 A. Braet, C. Weltens, and W. Sermeus, "Effectiveness of discharge interventions from hospital to home on hospital readmissions: A systematic review," JBI Database of Systematic Reviews and Implementation Reports, Vol.14, No.2, pp.106-173, 2016.   DOI
15 M. L. Yoon and Y. Eun, "Factors affecting the readmission experience of liver cirrhosis patients," Journal of the Korea Academia-Industrial Cooperation Society, Vol.21, No.5, pp.111-120, 2020.
16 S. F. Jencks, M. V. Williams, and E. A. Coleman, "Rehospitalizations among patients in the medicare fee-for-service program," New England Journal of Medicine, Vol.360, No.14, pp.1418-1428, 2009.   DOI
17 C. M. Ashton, D. J. Del Junco, J. Souchek, N. P. Wray, and C. L. Mansyur, "The association between the quality of inpatient care and early readmission: A meta-analysis of the evidence," Medical Care, Vol.35, No.10, pp.1044-1059, 1997.   DOI
18 M. P. Rogers, E. C. Peterson, T. M. Barry, M, S. Baker, P. C. Kuo, and H. M. Janiua, "Elements of the care environment influence coronary artery bypass surgery readmission," Surgery Open Science, vol.7, pp.12-17, 2022.   DOI
19 M. E. Bowdish, R. S. DAgostino, V. H. Thourani, T. A. Schwann, C. Krohn, N. Desai, D. M. Shahian, F. G. Fernandez, and V. Badhwar, "Sts adult cardiac surgery database: 2021 Update on Outcomes, Quality, and Research," The Annals of Thoracic Surgery, Vol.111, No.6, pp.1770-1780, 2021.   DOI
20 The Korea Heart Foundation, Table of Cardiovascular Disease Surgery Status in Korea. 2018-2019. https://www.heart.or.kr/Home/reference?page="D02"
21 J. Chan, F. Rosenfeldt, K. Chaudhuri, and S. Marasco, "Cardiac Surgery in Patients with a History of Malignancy: Increased Complication Rate but Similar Mortality," Heart, Lung and Circulation, Vol.21, No.5, pp.255-259, 2012.   DOI
22 S. W. Trooboff, P. C. Magnus, C. S. Ross, K. Chaisson, R. S. Kramer, R. E. Helm, H. Desaulniers, R. C. De La Rosa, B. M. Westbrook, D. Duquette, J. R. Brown, E. M. Olmstead, D. J. Malenka, and A. Iribarne, "A multi-center analysis of readmission after cardiac surgery: Experience of The Northern New England Cardiovascular Disease Study Group," J Card Surg, Vol.34, No.8, pp.655-662, 2019.   DOI
23 A. Redzek, M. Mironicki, A. Gvozdenovic, M. Petrovic, N, Cemerlic-Asic, A. IIic, and L. Velicki, "Predictors for hospital readmission after cardiac surgery," Journal of Cardiac Surgery, Vol.30, No.1, pp.1-6, 2015.   DOI
24 S. K. Berg, A. D. Zwisler, B. D. Pedersen, K. Haase, and K. L. Sibilitz, "Patient experiences of recovery after heart valve replacement: suffering weakness, struggling to resume normality," BMC Nursing, Vol.12, Vol.1, p.23, 2013.   DOI
25 H. Khoury, W. Ragalie, Y. Sanaiha, H. Boutros, S. Rudasill, R. J. Shemin, and P. Benharash, "Readmission after surgical aortic valve replacement in the united states," The Annals of Thoracic Surgery, Vol.110, No.3, pp.849-855, 2020.   DOI
26 R. P. Merkow, M. H. Ju, J. W. Chung, B. L. Hall, M. E. Cohen, M. V. Wiliams, T. C. Tsai, C. Y. Ko, and K. Y. Bilimoria, "Underlying reasons associated with hospital readmission following surgery in the united states," JAMA, Vol.313, No.5, pp.483-495, 2015.   DOI
27 J. A. Dodson, Y. Wang, K. Murugiah, K. Dhamarajan, Z. Cooper, S. Hashim, S. V. Nuti, E. Spatz, N. Desai, and H. M. Krumholz, "National trends in hospital readmission rates among medicare fee-for-service survivors of mitral valve surgery, 1999-2010," PLoS One, Vol.10, No.7, pp.1-11, 2015.
28 F. Farzadfar, "Cardiovascular disease risk prediction models: challenges and perspectives," The Lancet, Global Health, Vol.7, No.10, pp.e1288-e1289, 2019.   DOI