Abstract
BACKGROUND: We characterized index admission outcomes and 30-day readmissions after cardiac surgery in patients with chronic steroid use (CSU) in a large national administrative database. METHODS: Cardiac surgery patients (coronary artery bypass grafting, valve, aortic, and combinations) were identified in the 2016-2020 Nationwide Readmissions Database and stratified by CSU diagnosis. Mortality and complications during index admissions and 30-day readmissions were compared between patients with and without CSU after propensity score matching (PSM). RESULTS: Overall, 1,332,806 cardiac surgery patients were identified; 12,082 (0.91%) with CSU and 1,320,724 (99%) without. Before PSM, more CSU patients were ≥ 75 years-old and female, and had anemia, chronic lung disease, renal failure, and prior stroke. Following PSM, no significant differences in characteristics remained between 12,082 patients with CSU and 47,180 without. Index admission mortality (3.2% vs. 3.6%; P = .09) and overall complications (45% vs. 44%; P = .24) were not significantly different. 30-day readmissions were higher among those with CSU (16% vs. 13%; P < .01). Among readmitted patients, mortality (4.9% vs. 3.7%; P = .17) and overall complications (53% vs. 51%; P = .29) were not significantly different. CONCLUSIONS: Patients with CSU had higher baseline comorbidity burden but did not have higher index admission mortality or complications. Patients with CSU were more often readmitted within 30 days of discharge, but their outcomes during readmissions were like those in patients without CSU.