title: Readmission in the 30 days after percutaneous coronary intervention.
abstract: OBJECTIVE
  This study sought to identify the frequency and etiology of readmission within 30 days of percutaneous coronary intervention (PCI) in a large integrated healthcare system.
  
  
  BACKGROUND
  One-fifth of Medicare patients are readmitted within 30 days of hospitalization. Identifying the causes of readmission may help identify strategies to prevent readmission.
  
  
  METHODS
  All patients undergoing PCI (elective, urgent, and emergent) at our center between January 1, 2007, and April 12, 2010, were prospectively entered into the American College of Cardiology National Cardiovascular Data Registry. Patients readmitted to any hospital within 30 days of the index procedure were identified using an administrative database and telephone follow-up. Individual charts were reviewed independently by 2 investigators; disagreements regarding the cause for readmission were resolved by a third investigator.
  
  
  RESULTS
  During the study period, 3,255 PCI were performed, and 262 patients (8.0%) were readmitted within 30 days. Of these, 261 (99.6%) had medical records available for review. Reasons for readmission included: complications related to the PCI (n = 31, 11.9%); non-PCI cardiac causes related to index admission (n = 93, 35.6%); noncardiac causes related to index admission (n = 34, 13%); causes unrelated to the index admission (n = 103, 39.5%). Multivariable logistic regression modeling revealed that female sex, advanced age, peripheral arterial disease, prior valvular surgery, and PCI complications during the index procedure were associated with 30-day readmission.
  
  
  CONCLUSIONS
  Readmissions within 30 days due to complications related to PCI performed on index admission are rare (0.9% of all PCI) and are an infrequent cause of readmission (<12% of readmissions). Thirty-day readmission after PCI should not be used as a quality metric of PCI performance.
authors.affiliation: Department of Cardiology, Geisinger Medical Center, Danville, PA 17822, USA.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Yost
authors.forename: Stefanie L
authors.initials: SL
authors.lastname: Puher
authors.forename: Jove
authors.initials: J
authors.lastname: Graham
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Scott
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Skelding
authors.forename: Peter B
authors.initials: PB
authors.lastname: Berger
authors.forename: James C
authors.initials: JC
authors.lastname: Blankenship
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010359:Patient Readmission; D010414:Pennsylvania; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D019984:Quality Indicators, Health Care; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome