Abstract 35: Predictors and Etiologies of 30-Day Readmission Rate in Patients With Pulmonary Embolism: A National Population-Based Cohort Study

Abstract

Background: The hospitalization rates of patients with pulmonary embolism (PE) has been on the rise. However, there is limited data recognizing the etiologies and predictors of early readmission rate in this patient population. Methods: We utilized the National Readmission Database (NRD) 2013, subset of the Healthcare Cost and Utilization Project (HCUP) sponsored by the Agency for Healthcare Research and Quality (AHRQ). PE was identified using ICD 9 code (415.1X) as primary diagnosis. Co-morbidities identified by “CM_” variables provided by NRD. Primary outcome was identified as predictors of 30-day readmission rates and secondary outcomes as the leading etiologies and trends of readmission rate. To identify predictors of outcome, a two level hierarchical logistical model was used. Results: We analyzed 76,994 patients with primary diagnosis of PE. Total of 11.6% (8,934) patients were readmitted within 30 days of index hospitalization. Significant predictors of readmission were associated with end stage renal disease, drug abuse, chronic lung disease, congestive heart failure, and gastrointestinal bleed during primary admission. In addition, female gender, those admitted to teaching hospital and with longer length of stay (LOS) had higher 30-day readmission rate. Remarkably, elderly age (age>75 years) was not associated with increase in readmission rates. The leading etiologies besides DVT/PE for readmission were sepsis/septic shock, cancer, heart failure and pneumonia. Conclusion: The rising hospitalization rate of patients with pulmonary embolism, imposes a higher burden on the cost of health care. We identified important predictors and etiologies of 30-day readmission rate. These findings may help in prevention of hospital readmissions and may decrease the cost of care.