According to this new work (soon to be published in Ann Thorac Surg), discharging a patient during the weekend or a holiday after cardiac surgery is not associated with higher rates of readmission compared with patients discharged during weekdays.
A total of 4877 patients were discharged after cardiac surgery in high-volume sites in the United States. Among them, about 1 every 5 patients was discharged on a Saturday, Sunday, or holiday, and 11.4% had to be readmitted within 30 days.
Conversely, 10.9% of the patients who went home on a weekday had to go back to the hospital within the same period of time. The difference between cohorts is not significant.
Read also: Next-Day Discharge after TAVR: Is It Viable?
Discharge is a task that begins immediately after surgery and that must include a patient’s family so that, once s/he gets home, s/he has the necessary resources to meet expectations.
Several studies in diverse clinical contexts have shown an increase in the number of events upon admission during the weekend; however, according to this work, going home on a weekend does not entail the same risks.
Some comorbidities (older age, chronic obstructive pulmonary disease, dialysis, pleural effusion after surgery, or neurological complications) had previously been associated with more readmissions but were not predictors in this cohort.
Read also: Transradial Access and Early Discharge in Percutaneous Interventions.
Smoking and beta-blocker use were actually associated with more readmissions. However, in the case of beta-blockers, the problem may not lie in their use, but in the fact that they suggest a higher burden of ischemic disease.
Original title: Day of Discharge Does Not Impact Hospital Readmission After Major Cardiac Surgery.
Reference: Sanaiha Y et al. Ann Thorac Surg 2018; Epub ahead of print.
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