Preoperative White Blood Cell Count and Risk of 30-Day Readmission after Cardiac Surgery
Approximately 1 in 5 patients undergoing cardiac surgery are readmitted within 30 days of discharge. Among the primary causes of readmission are infection and disease states susceptible to the inflammatory cascade, such as diabetes, chronic obstructive pulmonary disease, and gastrointestinal compli...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | International Journal of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2013/781024 |
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| author | Jeremiah R. Brown R. Clive Landis Kristine Chaisson Cathy S. Ross Lawrence J. Dacey Richard A. Boss Robert E. Helm Susan R. Horton Patricia Hofmaster Cheryl Jones Helen Desaulniers Benjamin M. Westbrook Dennis Duquette Kelly LeBlond Reed D. Quinn Patrick C. Magnus David J. Malenka Anthony W. DiScipio |
| author_facet | Jeremiah R. Brown R. Clive Landis Kristine Chaisson Cathy S. Ross Lawrence J. Dacey Richard A. Boss Robert E. Helm Susan R. Horton Patricia Hofmaster Cheryl Jones Helen Desaulniers Benjamin M. Westbrook Dennis Duquette Kelly LeBlond Reed D. Quinn Patrick C. Magnus David J. Malenka Anthony W. DiScipio |
| author_sort | Jeremiah R. Brown |
| collection | DOAJ |
| description | Approximately 1 in 5 patients undergoing cardiac surgery are readmitted within 30 days of discharge. Among the primary causes of readmission are infection and disease states susceptible to the inflammatory cascade, such as diabetes, chronic obstructive pulmonary disease, and gastrointestinal complications. Currently, it is not known if a patient’s baseline inflammatory state measured by crude white blood cell (WBC) counts could predict 30-day readmission. We collected data from 2,176 consecutive patients who underwent cardiac surgery at seven hospitals. Patient readmission data was abstracted from each hospital. The independent association with preoperative WBC count was determined using logistic regression. There were 259 patients readmitted within 30 days, with a median time of readmission of 9 days (IQR 4–16). Patients with elevated WBC count at baseline (10,000–12,000 and >12,000 mm3) had higher 30-day readmission than those with lower levels of WBC count prior to surgery (15% and 18% compared to 10%–12%, P=0.037). Adjusted odds ratios were 1.42 (0.86, 2.34) for WBC counts 10,000–12,000 and 1.81 (1.03, 3.17) for WBC count > 12,000. We conclude that WBC count measured prior to cardiac surgery as a measure of the patient’s inflammatory state could aid clinicians and continuity of care management teams in identifying patients at heightened risk of 30-day readmission after discharge from cardiac surgery. |
| format | Article |
| id | doaj-art-d713641a6ce44f05ae4aa987010015f8 |
| institution | Kabale University |
| issn | 2090-8040 2042-0099 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Inflammation |
| spelling | doaj-art-d713641a6ce44f05ae4aa987010015f82025-02-03T05:58:57ZengWileyInternational Journal of Inflammation2090-80402042-00992013-01-01201310.1155/2013/781024781024Preoperative White Blood Cell Count and Risk of 30-Day Readmission after Cardiac SurgeryJeremiah R. Brown0R. Clive Landis1Kristine Chaisson2Cathy S. Ross3Lawrence J. Dacey4Richard A. Boss5Robert E. Helm6Susan R. Horton7Patricia Hofmaster8Cheryl Jones9Helen Desaulniers10Benjamin M. Westbrook11Dennis Duquette12Kelly LeBlond13Reed D. Quinn14Patrick C. Magnus15David J. Malenka16Anthony W. DiScipio17The Dartmouth Institute for Health Policy and Clinical Practice, Departments of Medicine Section of Cardiology and Community and Family Medicine and Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USAEdmund Cohen Laboratory for Vascular Research, The University of the West Indies, Bridgetown, BarbadosDepartment of Surgery, Concord Hospital, Concord, NH, USAThe Dartmouth Institute for Health Policy and Clinical Practice, Departments of Medicine Section of Cardiology and Community and Family Medicine and Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USADepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USADepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USADepartment of Surgery, Portsmouth Regional Hospital, Portsmouth, NH, USADepartment of Surgery, Central Maine Medical Center, Lewiston, ME, USADepartment of Surgery, Eastern Maine Medical Center, Bangor, ME, USADepartment of Surgery, Maine Medical Center, Portland, ME, USADepartment of Surgery, Catholic Medical Center, Manchester, NH, USADepartment of Surgery, Catholic Medical Center, Manchester, NH, USADepartment of Surgery, Portsmouth Regional Hospital, Portsmouth, NH, USADepartment of Surgery, Central Maine Medical Center, Lewiston, ME, USADepartment of Surgery, Maine Medical Center, Portland, ME, USAThe Dartmouth Institute for Health Policy and Clinical Practice, Departments of Medicine Section of Cardiology and Community and Family Medicine and Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USAThe Dartmouth Institute for Health Policy and Clinical Practice, Departments of Medicine Section of Cardiology and Community and Family Medicine and Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USADepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USAApproximately 1 in 5 patients undergoing cardiac surgery are readmitted within 30 days of discharge. Among the primary causes of readmission are infection and disease states susceptible to the inflammatory cascade, such as diabetes, chronic obstructive pulmonary disease, and gastrointestinal complications. Currently, it is not known if a patient’s baseline inflammatory state measured by crude white blood cell (WBC) counts could predict 30-day readmission. We collected data from 2,176 consecutive patients who underwent cardiac surgery at seven hospitals. Patient readmission data was abstracted from each hospital. The independent association with preoperative WBC count was determined using logistic regression. There were 259 patients readmitted within 30 days, with a median time of readmission of 9 days (IQR 4–16). Patients with elevated WBC count at baseline (10,000–12,000 and >12,000 mm3) had higher 30-day readmission than those with lower levels of WBC count prior to surgery (15% and 18% compared to 10%–12%, P=0.037). Adjusted odds ratios were 1.42 (0.86, 2.34) for WBC counts 10,000–12,000 and 1.81 (1.03, 3.17) for WBC count > 12,000. We conclude that WBC count measured prior to cardiac surgery as a measure of the patient’s inflammatory state could aid clinicians and continuity of care management teams in identifying patients at heightened risk of 30-day readmission after discharge from cardiac surgery.http://dx.doi.org/10.1155/2013/781024 |
| spellingShingle | Jeremiah R. Brown R. Clive Landis Kristine Chaisson Cathy S. Ross Lawrence J. Dacey Richard A. Boss Robert E. Helm Susan R. Horton Patricia Hofmaster Cheryl Jones Helen Desaulniers Benjamin M. Westbrook Dennis Duquette Kelly LeBlond Reed D. Quinn Patrick C. Magnus David J. Malenka Anthony W. DiScipio Preoperative White Blood Cell Count and Risk of 30-Day Readmission after Cardiac Surgery International Journal of Inflammation |
| title | Preoperative White Blood Cell Count and Risk of 30-Day Readmission after Cardiac Surgery |
| title_full | Preoperative White Blood Cell Count and Risk of 30-Day Readmission after Cardiac Surgery |
| title_fullStr | Preoperative White Blood Cell Count and Risk of 30-Day Readmission after Cardiac Surgery |
| title_full_unstemmed | Preoperative White Blood Cell Count and Risk of 30-Day Readmission after Cardiac Surgery |
| title_short | Preoperative White Blood Cell Count and Risk of 30-Day Readmission after Cardiac Surgery |
| title_sort | preoperative white blood cell count and risk of 30 day readmission after cardiac surgery |
| url | http://dx.doi.org/10.1155/2013/781024 |
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