title: Incidence and predictors of 30-day hospital readmission rate following percutaneous coronary intervention (from the National Heart, Lung, and Blood Institute Dynamic Registry).
abstract: Postdischarge outcomes after percutaneous coronary intervention (PCI) are important measurements of quality of care and complement in-hospital measurements. We sought to assess in-hospital and postdischarge PCI outcomes to (1) better understand the relation between acute and 30-day outcomes, (2) identify predictors of 30-day hospital readmission, and (3) determine the prognostic significance of 30-day hospital readmission. We analyzed in-hospital death and length of stay (LOS) and nonelective cardiac-related rehospitalization after discharge in 10,965 patients after PCI in the Dynamic Registry. From 1999 to 2006 in-hospital death rate and LOS decreased. Thirty-day cardiac readmission rate was 4.6%, with considerable variability over time and among hospitals. Risk of rehospitalization was greater in women and those with congestive heart failure, unstable angina, multiple lesions, and emergency PCI. Conversely, a lower risk of rehospitalization was associated with a larger number of treated lesions. Patients readmitted within 30 days had higher 1-year mortality than those free from hospital readmission. In conclusion, although in-hospital mortality and LOS after PCI have decreased over time, the observed 30-day cardiac readmission rate was highly variable and risk of readmission was more closely associated with underlying patient characteristics than procedural characteristics.
authors.affiliation: Division of Cardiology, University of New Mexico School of Medicine, Albuquerque, New Mexico. mricciardi@salud.unm.edu
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Ricciardi
authors.forename: Faith
authors.initials: F
authors.lastname: Selzer
authors.forename: Oscar C
authors.initials: OC
authors.lastname: Marroquin
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Holper
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Venkitachalam
authors.forename: David O
authors.initials: DO
authors.lastname: Williams
authors.forename: Sheryl F
authors.initials: SF
authors.lastname: Kelsey
authors.forename: Warren K
authors.initials: WK
authors.lastname: Laskey
mesh_terms: D000047:Academies and Institutes / Q000706:statistics & numerical data*; D000368:Aged; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D062645:Percutaneous Coronary Intervention; D012042:Registries; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology