{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:32:40Z","timestamp":1787776360203,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The need for reinstitution of intensive care unit (ICU) care (\u201crecidivism\u201d) in post-cardiac surgery patients is associated with increased morbidity, mortality, resource use, and healthcare costs. Recidivism is propounded as a quality indicator of ICU care. There is a paucity of studies from India regarding cardiac surgical ICU readmissions, their outcomes, and risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Nested case-control study including 1,711 consecutive adult patients who underwent cardiac surgery over a two-year period at a tertiary care institute. The patients were grouped into recidival (R) and control (C) groups. The reasons for readmission, outcomes, and predictive risk factors were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Fifty-four of 1,711 (3.1%) patients were readmitted to ICU, main reasons being cardiac arrhythmias (24, 41%), pericardial effusion (9, 15.2%), and infection (8, 13.5%). Readmission was significantly higher for valvular interventions (39 patients, 24.3%, mitral valve 25 patients) than coronary artery bypass grafting (13, 10.6%), P value 0.003*. On multivariate analysis, EuroSCORE 2 (&gt;5), age, surgical reexploration, postoperative pulmonary complications, and infections were independently associated with a need for ICU readmission. The mortality rate among the readmitted patients was 7.4% compared to 1.4% overall mortality. The mean total postoperative length of stay was significantly longer for recidival patients (17.6 \u00b1 14 days vs 7.6 \u00b1 2.4 days; P &lt; 0.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Recidivism is associated with longer hospital stay, suboptimal outcomes as well higher risk of mortality. Postoperative cardiac dysrhythmia was the most common cause of recidivism in our cohort. Early identification of patients at risk for recidivism and timely management of cardiopulmonary complications can translate to better outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_68_24","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T10:01:12Z","timestamp":1728036072000},"page":"330-336","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Recidivism in Cardiac Surgical ICU: Can this Understanding Translate to Enhanced Patient Outcomes?"],"prefix":"10.4103","volume":"27","author":[{"given":"Raj","family":"Sahajanandan","sequence":"first","affiliation":[{"name":"Department of Cardiac Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A V","family":"Varsha","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay M.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben B.","family":"Kurien","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Korah","family":"Kuruvilla","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Thankachen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhu A.","family":"Philip","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"R1-20241226","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1097\/00003246-198511000-00037","article-title":"Readmission of patients to the surgical intensive care unit: Patient profiles and possibilities for prevention","volume":"13","author":"Snow","year":"1985","journal-title":"Crit Care Med"},{"key":"R2-20241226","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1378\/chest.118.2.492","article-title":"Patients readmitted to ICUs: A systematic review of risk factors and outcomes","volume":"118","author":"Rosenberg","year":"2000","journal-title":"Chest"},{"key":"R3-20241226","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.ejcts.2004.11.016","article-title":"The predictors and outcome of recidivism in cardiac ICUs","volume":"27","author":"Vohra","year":"2005","journal-title":"Eur J Cardiothorac Surg"},{"key":"R4-20241226","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1513\/AnnalsATS.201611-851OC","article-title":"Readmission to the intensive care unit: Incidence, risk factors, resource use, and outcomes. 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