Home Transition Program Cuts Readmission, Death Post-CABG
Innovative program involving cardiac surgery nurse practitioners reduces composite end point
THURSDAY, May 1, 2014 (HealthDay News) -- For patients discharged home after coronary artery bypass graft (CABG) operations, a transitional program involving cardiac surgery nurse practitioners can reduce a composite end point of 30-day readmission and death, according to a study published online May 1 in the Annals of Thoracic Surgery.
Michael H. Hall, M.D., M.B.A., from the North Shore University Hospital in Manhasset, N.Y., and colleagues designed and tested an innovative transitional care program involving cardiac surgery nurse practitioners. Four hundred and one patients with CABG were eligible for analysis, of whom 169 were enrolled in the "Follow Your Heart" program, while 232 controls received usual care. Readmission predictors were identified and propensity score matching with 13 covariates was performed.
The researchers found that "Follow Your Heart" was the only independent significant variable in preventing the composite outcome of 30-day readmission and death (P = 0.015) in binary logistic regression analysis. The likelihood of remission was increased for dialysis patients, Medicaid recipients, women, and non-Caucasians (odds ratios for readmission, 3.11, 2.17, 1.87, and 1.86, respectively), and for those with chronic obstructive pulmonary disease, diabetes, and congestive heart failure (odds ratios, 1.78, 1.26, and 1.09, respectively). In propensity score matching analysis for 156 intervention patients, 30-day readmission was significantly lower for the intervention compared with the matched usual care group (3.85 versus 11.54 percent; P = 0.023).
"A home transition program providing continuity of care, communication hub, and medication management by treating hospital nurse practitioners significantly reduced the 30-day composite end point of readmission/death after CABG," the authors write.