OBJECTIVES: This study sought to identify the frequency and etiology of readmission within 30 days of percutaneous coronary intervention (PCI) in a large integrated healthcare system. BACKGROUND: One-fifth of Medicare patients are readmitted within 30 days of hospitalization. Identifying the causes of readmission may help identify strategies to prevent readmission. METHODS: All patients undergoing PCI (elective, urgent, and emergent) at our center between January 1, 2007, and April 12, 2010, were prospectively entered into the American College of Cardiology National Cardiovascular Data Registry. Patients readmitted to any hospital within 30 days of the index procedure were identified using an administrative database and telephone follow-up. Individual charts were reviewed independently by 2 investigators; disagreements regarding the cause for readmission were resolved by a third investigator. RESULTS: During the study period, 3,255 PCI were performed, and 262 patients (8.0%) were readmitted within 30 days. Of these, 261 (99.6%) had medical records available for review. Reasons for readmission included: complications related to the PCI (n = 31, 11.9%); non-PCI cardiac causes related to index admission (n = 93, 35.6%); noncardiac causes related to index admission (n = 34, 13%); causes unrelated to the index admission (n = 103, 39.5%). Multivariable logistic regression modeling revealed that female sex, advanced age, peripheral arterial disease, prior valvular surgery, and PCI complications during the index procedure were associated with 30-day readmission. CONCLUSIONS: Readmissions within 30 days due to complications related to PCI performed on index admission are rare (0.9% of all PCI) and are an infrequent cause of readmission (<12% of readmissions). Thirty-day readmission after PCI should not be used as a quality metric of PCI performance.
OBJECTIVES: This study sought to identify the frequency and etiology of readmission within 30 days of percutaneous coronary intervention (PCI) in a large integrated healthcare system. BACKGROUND: One-fifth of Medicare patients are readmitted within 30 days of hospitalization. Identifying the causes of readmission may help identify strategies to prevent readmission. METHODS: All patients undergoing PCI (elective, urgent, and emergent) at our center between January 1, 2007, and April 12, 2010, were prospectively entered into the American College of Cardiology National Cardiovascular Data Registry. Patients readmitted to any hospital within 30 days of the index procedure were identified using an administrative database and telephone follow-up. Individual charts were reviewed independently by 2 investigators; disagreements regarding the cause for readmission were resolved by a third investigator. RESULTS: During the study period, 3,255 PCI were performed, and 262 patients (8.0%) were readmitted within 30 days. Of these, 261 (99.6%) had medical records available for review. Reasons for readmission included: complications related to the PCI (n = 31, 11.9%); non-PCI cardiac causes related to index admission (n = 93, 35.6%); noncardiac causes related to index admission (n = 34, 13%); causes unrelated to the index admission (n = 103, 39.5%). Multivariable logistic regression modeling revealed that female sex, advanced age, peripheral arterial disease, prior valvular surgery, and PCI complications during the index procedure were associated with 30-day readmission. CONCLUSIONS: Readmissions within 30 days due to complications related to PCI performed on index admission are rare (0.9% of all PCI) and are an infrequent cause of readmission (<12% of readmissions). Thirty-day readmission after PCI should not be used as a quality metric of PCI performance.
Authors: Mayra Tisminetzky; David D McManus; Nathaniel Erskine; Jane S Saczynski; Jorge Yarzebski; Edgard Granillo; Joel Gore; Robert J Goldberg Journal: Am J Med Date: 2015-02-03 Impact factor: 4.965
Authors: Chris Song; Devraj Sukul; Milan Seth; James M Dupree; Akshay Khandelwal; Simon R Dixon; David Wohns; Thomas LaLonde; Hitinder S Gurm Journal: Am J Cardiol Date: 2017-08-30 Impact factor: 2.778
Authors: Mayra Tisminetzky; Jordy Mehawej; Ruben Miozzo; Jerry H Gurwitz; Joel M Gore; Darleen Lessard; Hawa O Abu; Benita A Bamgbade; Jorge Yarzebski; Edgard Granillo; Robert J Goldberg Journal: Am J Med Date: 2021-04-20 Impact factor: 5.928
Authors: Jason H Wasfy; Jordan B Strom; Stephen W Waldo; Cashel O'Brien; Neil J Wimmer; Adrian H Zai; Jennifer Luttrell; John A Spertus; Kevin F Kennedy; Sharon-Lise T Normand; Laura Mauri; Robert W Yeh Journal: J Am Heart Assoc Date: 2014-09-26 Impact factor: 5.501