Early Discharge after Isolated CABG does not Increase 30-Day Readmission

Abstract

Background We aimed to evaluate the relationship between early discharge and 30-day readmission after isolated coronary artery bypass grafting (CABG). Methods This retrospective study included all consecutive adults undergoing isolated CABG in a single tertiary institution between May 2023 and December 2024. Patients with concomitant cardiac procedures, in-hospital mortality, or prolonged hospitalization (> 14 days) were excluded. Patients were categorized into early (≤ 5 days) and late (> 5 days) discharge groups. The primary outcome was 30-day all-cause unplanned readmission. The secondary outcome was 30-day all-cause emergency room presentation. Results The final cohort consisted of 1,470 patients. The 30-day unplanned readmission rate was significantly lower in the early-discharge group compared with the late-discharge group (6.7% vs. 12.0%, p  = 0.001). In univariable analysis, advanced age, increased length of hospital stay, cardiopulmonary bypass (CPB) time, mechanical ventilation duration, postoperative atrial fibrillation, and need for surgical reexploration were significantly associated with an increased risk of hospital readmission. In multivariable analysis, early discharge was not an independent predictor of 30-day readmission (odds ratio [OR]: 0.714, 95% confidence interval [CI]: 0.470–1.085, p  = 0.114). Multivariable analysis identified increased CPB time (OR: 1.008, 95% CI: 1.003–1.013, p  = 0.003) and surgical reexploration (OR: 2.479, 95% CI: 1.283–4.788, p  = 0.007) as independent predictors of 30-day readmission. Conclusion In selected low-risk patients with an uncomplicated postoperative course, early discharge after isolated CABG was not independently associated with increased 30-day readmission. Longer CPB time and surgical reexploration were independently associated with readmission.