Chun Shing Kwok1,2, Saurav Chatterjee3, Rodrigo Bagur1, Kamal Sharma4, M Chadi Alraies5, David Fischman6, Michael Savage6, Mohamed Mohamed1,2, Ahmad Shoaib1, Tejas Patel7, Mamas A Mamas1,2. 1. Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK. 2. Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK. 3. Division of Cardiovascular Medicine, Hoffman Heart Institute, Saint Francis Hospital, Teaching Affiliate of the University of Connecticut School of Medicine, Hartford, Connecticut. 4. Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, India. 5. Department of Cardiology, Detroit Medical Center, Detroit Heart Hospital, Wayne State University, Detroit, Michigan. 6. Department of Medicine (Cardiology), Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. 7. Department of Cardiology, Apex Heart Institute, Ahmedabad, India.
Abstract
OBJECTIVE: This study aims to describe temporal trends, characteristics, and clinical outcomes of patients with more than one unplanned readmission within 30 and 180 days after admission with percutaneous coronary intervention (PCI). BACKGROUND: There is limited understanding of multiple readmissions after PCI. METHODS: Patients undergoing PCI between 2010 and 2014 in the U.S. Nationwide Readmission Database were evaluated for unplanned readmissions at 30 and 180 days after discharge. Trends in multiple readmissions, characteristics of patients, and causes of first readmissions are described. RESULTS: A total of 2,324,194 patients were included in the analysis of 30-day unplanned readmissions and 1,327,799 patients in the analysis of 180-day unplanned readmission. The proportions of patients with a single readmission and multiple readmissions within 30 days were 8.5 and 1.0% and at 180 days were 15.4 and 9.1%, respectively. Common reasons for first readmission among patients with multiple readmissions were coronary artery disease, including angina, heart failure, and acute myocardial infarction. Factors associated with multiple readmissions were discharge against medical advice, discharge to care home, renal failure, and liver failure. The total cost of multiple readmissions is significant, with an increase from ~$20,000 for no readmission to over $60,000 at 30-day follow up and $86,000 at 180-day follow up. CONCLUSIONS: Multiple readmissions are rare within 30 days after PCI but increase to nearly 1 in 10 patients at 180 days, and 20-25% of patients who have multiple readmissions are readmitted for the same cause as for the first and second readmissions.
OBJECTIVE: This study aims to describe temporal trends, characteristics, and clinical outcomes of patients with more than one unplanned readmission within 30 and 180 days after admission with percutaneous coronary intervention (PCI). BACKGROUND: There is limited understanding of multiple readmissions after PCI. METHODS:Patients undergoing PCI between 2010 and 2014 in the U.S. Nationwide Readmission Database were evaluated for unplanned readmissions at 30 and 180 days after discharge. Trends in multiple readmissions, characteristics of patients, and causes of first readmissions are described. RESULTS: A total of 2,324,194 patients were included in the analysis of 30-day unplanned readmissions and 1,327,799 patients in the analysis of 180-day unplanned readmission. The proportions of patients with a single readmission and multiple readmissions within 30 days were 8.5 and 1.0% and at 180 days were 15.4 and 9.1%, respectively. Common reasons for first readmission among patients with multiple readmissions were coronary artery disease, including angina, heart failure, and acute myocardial infarction. Factors associated with multiple readmissions were discharge against medical advice, discharge to care home, renal failure, and liver failure. The total cost of multiple readmissions is significant, with an increase from ~$20,000 for no readmission to over $60,000 at 30-day follow up and $86,000 at 180-day follow up. CONCLUSIONS: Multiple readmissions are rare within 30 days after PCI but increase to nearly 1 in 10 patients at 180 days, and 20-25% of patients who have multiple readmissions are readmitted for the same cause as for the first and second readmissions.