Predictors and outcomes of emergency department visits within 30 days following percutaneous coronary intervention.
Our objective was to determine the frequency and predictive factors for cardiac-related emergency department (ED) encounters within 30 days after percutaneous coronary intervention (PCI). The data source was an electronic database of 2,731 patients who had PCI from 2002 to 2004. Almost all underwent stent placement. Risk factors for returning to the ED were identified from clinical, anatomic, and demographic candidate variables using multivariate logistic regression. Approximately 9% of the cohort (255 of 2,731 patients) returned to the ED for cardiac reasons within 30 days, peaking around 3 days. ED visits were more likely in those whose index PCI was emergent or urgent (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.3 to 3.0), in women (OR 1.9, 95% CI 1.5 to 2.5), and in those who had previous encounters with the ED or hospital (OR 1.7, 95% CI 1.5 to 2.0). Patients receiving stents were somewhat less likely to return (OR 0.7, 95% CI 0.5 to 1.0). In conclusion, the clinical courses of the 255 returning patients were generally benign, but 12% had a subsequent myocardial infarction or repeat PCI within 30 days of the ED encounter.
Hubbard
Bradley L
BL
Michigan Heart P.C., St. Joseph Mercy Hospital, Ann Arbor, Michigan, USA.
Vedala
Giridhar
G
Strawderman
Robert L
RL
Cowen
Mark E
ME
D015906:Angioplasty, Balloon, Coronary; D016001:Confidence Intervals; D003325:Coronary Care Units / Q000706:statistics & numerical data*; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009819:Office Visits / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome