Thirty-day readmission after endovascular or surgical revascularization for chronic mesenteric ischemia: Insights from the Nationwide Readmissions Database

Abstract

There are limited contemporary data on readmission after revascularization for chronic mesenteric ischemia (CMI). This study aimed to determine the rates, reasons, predictors, and costs of 30-day readmission after endovascular or surgical revascularization for CMI. Patients with CMI discharged after endovascular or surgical revascularization during 2013 to 2014 were identified from the Nationwide Readmissions Database. The rates, reasons, length of stay, and costs of 30-day all-cause, non-elective, readmission were determined using weighted national estimates. Independent predictors of 30-day readmission were determined using hierarchical logistic regression. Among 4671 patients with CMI who underwent mesenteric revascularization, 19.5% were readmitted within 30 days after discharge at a median time of 10 days. More than 25% of readmissions were for cardiovascular or cerebrovascular conditions, most of which were for peripheral or visceral atherosclerosis and congestive heart failure. Independent predictors of 30-day readmission included non-elective index admission, chronic kidney disease (CKD), and discharge to home healthcare or to a skilled nursing facility. Revascularization modality did not independently predict readmission. In a nationwide, retrospective analysis of patients with CMI undergoing revascularization, approximately one in five were readmitted within 30 days. Predictors were largely non-modifiable and included non-elective index admission, CKD, and discharge disposition.

Acute Mesenteric Ischemia Remains a Highly Morbid Diagnosis after Initial Hospitalization Survival

“…In a recent report for patients with chronic mesenteric ischemia, it was noted that cardiovascular and cerebrovascular events were the culprit for their readmission. 17 Furthermore, the rate of readmission was comparatively higher in the chronic mesenteric ischemia patient population (19.5 vs. our 9.9% readmission rate for AMI in our present study). This could be possibly explained by the fact that the majority of AMI patients expire during their index hospitalization.…”

Thirty‐day readmissions after atrial fibrillation catheter ablation in patients with heart failure

“…Discharge to SNF was noted as the most powerful predictor of 30‐day readmission among the CA patient group. In the previous work, we 31 and others 32,33 have observed that discharge to SNF was a significant predictor of readmission after other cardiovascular procedures. This is not unexpected as patients discharged to SNF or HHC have historically been associated with a higher degree of comorbidities and frailty, which in turn may drive readmissions and may not be modifiable 34,35 .…”

Predictors of 30-Day Unplanned Readmission After Carotid Artery Stenting Using Artificial Intelligence

“…Prior studies looking at readmissions have shown a variety of readmission rates, including vascular interventions in Medicare patients (24%) [ 17 ], endovascular aortic aneurysm repair (10.2%) [ 18 ], lower extremity bypass (14.8%) [ 19 ], endovascular or surgical revascularization for chronic mesenteric ischemia (19.5%) [ 20 ], and revascularization for critical limb ischemia (20.4%) [ 21 ]. Looking specifically at the readmission rates in the CAS population, most prior studies have compared CEA readmission rates versus CAS.…”