Charan Yerasi1, Byomesh Tripathi1, Sandeep Banga2, Camila McNown3, Anil K Jonnalagadda4, Saifuldeen Al-Qaisi1, Varun Miryala5, Sina Nafisi4, Ron Waksman6, Itsik Ben-Dor1. 1. MedStar Washington Hospital Center, Washington, DC, United States of America. 2. University of Illinois College of Medicine, Peoria, IL, United States of America. 3. Banner University Medical Center, Phoenix, AZ, United States of America. 4. St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States of America. 5. St. Francis Medical Center, Trenton, NJ, United States of America. 6. MedStar Washington Hospital Center, Washington, DC, United States of America. Electronic address: ron.waksman@medstar.net.
Abstract
BACKGROUND: Takotsubo cardiomyopathy (TC) is diagnosed in 1% to 2% of patients presenting with suspected acute coronary syndromes. Readmission patterns after TC have been less studied. Thus, we sought to perform a study to evaluate the etiologies, trends, and predictors of 90-day readmission in TC. METHODS: The Nationwide Readmissions Database (NRD), 2014, was used to select the study cohort. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic code 429.83 was used to identify TC. Admissions within 90 days of index admission were considered early readmissions. Readmission etiologies were identified by an ICD-9-CM code. Hierarchical multivariate models were used to evaluate predictors of early readmission. RESULTS: A total of 28,079 patients were identified during the study period, of whom 24.3% (n = 6841) were readmitted within 90 days of discharge. In-hospital mortality during index admissions was 5.69%. The most common etiologies for readmission were cardiac (18.56%), respiratory (17.20%), and infections (13.12%). Among cardiac complications, acute heart failure was the most common etiology (7.48%). The highest number of readmissions happened on the first day after discharge (n = 125). On multivariate analysis, the age of 50-64 years, diabetes, heart failure, chronic pulmonary disease, peripheral vascular disease, anemia, and malignancy were shown to be significant predictors of readmission. Patients of female gender are less likely to be readmitted and have lower in-hospital mortality. CONCLUSIONS: Patients with TC are highly likely to be readmitted within the first month after discharge, most likely with secondary to cardiac or respiratory complications. These findings warrant close post-discharge transition to reduce morbidity and improve healthcare outcomes. SUMMARY: This analysis from the Nationwide Readmission Database outlines a detailed analysis on etiologies, trends, and predictors of 90-day readmission for patients presenting with takotsubo cardiomyopathy.
BACKGROUND:Takotsubo cardiomyopathy (TC) is diagnosed in 1% to 2% of patients presenting with suspected acute coronary syndromes. Readmission patterns after TC have been less studied. Thus, we sought to perform a study to evaluate the etiologies, trends, and predictors of 90-day readmission in TC. METHODS: The Nationwide Readmissions Database (NRD), 2014, was used to select the study cohort. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic code 429.83 was used to identify TC. Admissions within 90 days of index admission were considered early readmissions. Readmission etiologies were identified by an ICD-9-CM code. Hierarchical multivariate models were used to evaluate predictors of early readmission. RESULTS: A total of 28,079 patients were identified during the study period, of whom 24.3% (n = 6841) were readmitted within 90 days of discharge. In-hospital mortality during index admissions was 5.69%. The most common etiologies for readmission were cardiac (18.56%), respiratory (17.20%), and infections (13.12%). Among cardiac complications, acute heart failure was the most common etiology (7.48%). The highest number of readmissions happened on the first day after discharge (n = 125). On multivariate analysis, the age of 50-64 years, diabetes, heart failure, chronic pulmonary disease, peripheral vascular disease, anemia, and malignancy were shown to be significant predictors of readmission. Patients of female gender are less likely to be readmitted and have lower in-hospital mortality. CONCLUSIONS:Patients with TC are highly likely to be readmitted within the first month after discharge, most likely with secondary to cardiac or respiratory complications. These findings warrant close post-discharge transition to reduce morbidity and improve healthcare outcomes. SUMMARY: This analysis from the Nationwide Readmission Database outlines a detailed analysis on etiologies, trends, and predictors of 90-day readmission for patients presenting with takotsubo cardiomyopathy.
Authors: David Zweiker; Edita Pogran; Laura Gargiulo; Ahmed Abd El-Razek; Ivan Lechner; Ivan Vosko; Stefan Rechberger; Heiko Bugger; Günter Christ; Diana Bonderman; Evelyn Kunschitz; Clara Czedik-Eysenberg; Antonia Roithinger; Valerie Weihs; Christoph C Kaufmann; Andreas Zirlik; Axel Bauer; Bernhard Metzler; Thomas Lambert; Clemens Steinwender; Kurt Huber Journal: Biology (Basel) Date: 2022-08-01