Abstract:
:We investigated the incidence and determinants of early and late repeat hospitalization for cardiac causes in 378 patients following myocardial revascularization [199 coronary balloon angioplasty (PTCA), 179 coronary bypass surgery (CABG)] in a single cardiovascular center and followed for a median period of 13 years. Data were available for repeat rehospitalization in 91% and for mortality in all. Patients in the upper quartile for repeat hospitalization (>or=4 rehospitalizations) were defined as having multiple repeat hospitalizations. In the PTCA cohort, the rehospitalization rate was high (48%) in the first year, partly due to restenosis and to a group of patients who underwent planned repeat angiography, and then 15-26% annually. In the surgical cohort, annual repeat hospitalization was 8-12% during the first 4 years, but increased to a level similar to that in PTCA patients (19-26%) in the second half of the follow-up period. Independent predictors of multiple (>or=4) repeat hospitalizations included systemic hypertension (odds ratio 2.4, 95% CI 1.4-4.0), incomplete revascularization (odds ratio 2.0, 95% CI 1.1-3.4) and less extensive (<3 vessels) disease at the time of the index procedure (odds ratio 2.0, 95% CI 1.1-3.4). Predictors of repeat hospitalization were different from those of mortality (diabetes mellitus, 3-vessel disease). Late repeat hospitalizations after myocardial revascularization impose a considerable burden on the patient and the health care system, and represent an issue which should be better addressed.
journal_name
Cardiologyjournal_title
Cardiologyauthors
Halon DA,Rennert HS,Flugelman MY,Jaffe R,Lewis BSdoi
10.1159/000064681subject
Has Abstractpub_date
2002-01-01 00:00:00pages
67-74issue
1-2eissn
0008-6312issn
1421-9751pii
64681journal_volume
98pub_type
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