Very Early Discharge After Coronary Artery Bypass Grafting Does Not Impact Readmission or Survival

Abstract Background This study evaluated the impact of very early hospital discharge following coronary artery bypass grafting (CABG) on subsequent readmission and survival. Methods Adults undergoing isolated CABG from 2011 to 2018 at a single institution were included. Patients were stratified based on their postoperative length of hospital stay: short (≤4 days) and non-short stay (>4 days). The primary outcomes were longitudinal survival and freedom from hospital readmission. Secondary outcomes included rates of postoperative complications. Propensity score matching with a 1:1 ratio was performed to generate cohorts with comparable baseline characteristics. Results 6,327 patients underwent CABG during the study period and a matched cohort of 2,286 patients was identified. In matched analysis, the average Society of Thoracic Surgeons predicted risk of operative mortality was low in both groups (average 0.7%). Rates of postoperative complications were low and several complication rates were even lower in the short stay cohort: stroke (1.14% vs 0.26%, p=0.01), renal failure (0.87% vs 0.09%, p=0.007), reoperations (1.84% vs 0.26%, p 0.05). Readmission rates were also comparable at all time intervals and there were no differences in cardiac-related or heart failure-specific readmissions (all p>0.05). Risk-adjusted analyses confirmed these findings. Conclusions This study demonstrates that very early discharge within 4 days of isolated CABG is safe and has no substantial impact on subsequent mortality or readmission risk.