Multiple unplanned readmissions after discharge for an admission with percutaneous coronary intervention

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.

Relationship between dynamic changes of peri-procedure anxiety and short-term prognosis in patients undergoing elective percutaneous coronary intervention for coronary heart disease: A single-center, prospective study

“…In this study, the readmission rate of patients was about 25%, higher than the results of many domestic and foreign studies [37][38][39]. Readmissions due to hypertension accounted for 48.15% of total readmissions.…”

Troponin Levels at Presentation Before Coronary Angiogram and Their Association With Cost, Mortality, and Readmission

“…Recent studies, however, have suggested a lack of clarity regarding this hypothesis. Given that PCI is an increasingly common procedure in the United States (US) with high rates of readmission, this ambiguity is concerning [ 5 , 6 ]. Compelling evidence has even revealed a lack of complete understanding surrounding the biochemical mechanisms of cardiac troponin release, which further challenges these previous notions [ 7 ].…”

Symptom clusters and unplanned hospital readmission in Chinese patients with acute myocardial infarction on admission

“…It showed nearly 20% of patients were readmitted for cardiovascular events within 1 year of PCI in the previous study ( 20 ). Thus unplanned readmission in the early post-procedure period after PCI is considered to be a costly and common adverse outcome ( 20 , 21 ).…”