Post Coronary Artery Bypass Graft (CABG) Readmissions and Complications
During 2022–2023, 17.5% of CABG cases readmitted within 30 days experienced complications that may have been preventable, including deep sternal infections, post-operative renal failure, post-operative stroke, prolonged ventilation, re-operation for bleed, or unplanned reintervention. Post-operative atrial fibrillation, a common complication, occurred in 32.6% of CABG cases readmitted within 30 days.
Introduction
Following coronary artery bypass grafting (CABG) surgery, patients readmitted within 30 days of discharge were more likely to have experienced post-operative complications than patients without readmission. Post-operative complications can impact patient outcomes and quality of life. This visualization helps healthcare providers identify and understand the high-risk and low-risk complications that may result in patient readmission. The purpose of this visualization is to identify the impactful surgical quality outcomes that support efforts to minimize post-operative complications and reduce readmissions.
The potentially avoidable or preventable complications following CABG surgery include deep sternal infection, post-operative renal failure, post-operative stroke, prolonged ventilation, re-operation for bleed, and unplanned reintervention. Unplanned reinterventions include unplanned percutaneous coronary intervention (PCI) or unplanned surgical intervention on a coronary artery. The visualization shows CABG cases with any of these complications and CABG cases with two or more complications. Post-operative atrial fibrillation is also displayed but is not included in the “Any Complications” or “Two or More Complications” because it is a common cardiac surgery complication. Post-operative atrial fibrillation is a clinically relevant complication that can affect long-term cardiovascular health and patient outcomes, including an increased risk of stroke and mortality.1,2
This visualization uses data from the California Cardiovascular Outcomes Reporting Program (CCORP) from 2018 to 2023. Two consecutive years of data were combined to present more stable trends due to low frequency of CABG readmissions and complications. This approach is consistent with CCORP’s mandated CABG outcomes reporting for 30-day readmission measures. These years represent the most recent data available for CCORP’s mandated annual performance reporting. Proportion of complications by readmission status can be further stratified by payer type and patient characteristics, such as age, assigned sex at birth, and race/ethnicity. The key findings below correspond to the latest reporting period, the 2022–2023 two-year interval.
Key Findings for 2022–2023
- CABG cases readmitted within 30 days were twice as likely to have experienced deep sternal infection, post-operative renal failure, post-operative stroke, prolonged ventilation, or two or more complications at once.
- While less than one percent of CABG cases experienced unplanned reinterventions— PCI or unplanned surgical intervention — these reinterventions were 40% more likely among cases readmitted within 30 days than those without readmission.
- 17.5% of CABG cases readmitted within 30 days had any one of the following: deep sternal infection, post-operative renal failure, post-operative stroke, prolonged ventilation, re-operation for bleed, or unplanned reintervention.
- Post-operative atrial fibrillation is a common complication among CABG cases. 32.6% of cases readmitted within 30 days experienced atrial fibrillation compared to 27.3% of cases without readmission.
- Similar patterns of post-operative complications by readmission were observed between race/ethnicity, assigned sex at birth, and payer type categories. However, due to the low number of CABG cases for some groups, these patterns varied year-to-year, particularly among those younger than 40 years old, Native American patients, or uninsured patients.
Visualization
How HCAI Created This Product
Complete definitions for post-CABG complications, and other data resources, are available below.
Additional Information
Topic: Healthcare Quality
Source Link: Coronary Artery Bypass Graft Reports
Citation: HCAI – California Hospital Performance Ratings for Coronary Artery Bypass Graft (CABG) Surgery Data, 2018-2023
Temporal Coverage: 2018-2023
Spatial/Geographic Coverage: Statewide
Frequency: Annually
References
- Benedetto U, Gaudino MF, Dimagli A, et al. Postoperative atrial fibrillation and long-term risk of stroke after isolated coronary artery bypass graft surgery. Circulation. 2020;142(14):1320-1329. doi:10.1161/CIRCULATIONAHA.120.046940
- Oraii A, Masoudkabir F, Pashang M, et al. Effect of postoperative atrial fibrillation on early and mid-term outcomes of coronary artery bypass graft surgery. European Journal of Cardio-Thoracic Surgery. 2022;62(3):ezac264. doi:10.1093/ejcts/ezac264