Postoperative Coronary Artery Bypass Graft Readmissions in Rural, Remote and Northern Communities: Case Control Study focused on the Social Determinants of Health

May 23, 2025 from 11:35am EST to 12:05pm EST

People living in rural, remote and Northern communities (RRNC) are at greater risk for hospital readmissions post-coronary artery bypass graft (CABG). We aimed to identify the contributing factors, including social determinants of health (SDOH), associated with hospital readmission post-CABG in RRNC. In this case-control study from one Northern Ontario hospital, we reviewed 44 patients’ charts, all of whom were readmitted within 30-days of CABG between 2021 and 2023. The control group included 44 patients matched by age and sex. Logistic regression analysis revealed that readmission was associated with previous myocardial infarction (OR 2.517; CI 1.493-4.242), wait time for surgery (OR 1.016; CI 1.003-1.030), town of residence (OR 0.183; CI 0.066-0.512), distance from hospital (OR 1.010, CI 1.005 – 1.015), and need for community care upon discharge (OR 14.968; CI 4.026-55.645). Therefore, factors for readmission were less associated with patient health related factors but rather related to health services, physical environment, and community related factors, which all consist within the SDOH. Nursing implications include considering the latter factors within clinical practice, education, research, and health policy. A shift in focus in nursing practice should be to improve care planning and management of patients undergoing CABG during their cardiac health journey from diagnosis to treatment, and to discharge into the community.

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