Preoperative ICD risk score variables predict 30-day readmission after implantable cardioverter defibrillator implantation in patients with heart failure.
OBJECTIVE
To determine if preoperative ICD Risk Score for Adverse Outcome (ICD-RSAO) would predict need for hospital 30-day readmission.


BACKGROUND
Pre-analysis of National Cardiovascular Data Registry ICD database identified preoperative predictors of adverse outcomes associated with ICD implantation.


METHODS
Logistic regression, descriptive statistics and Chi-square were used to examine the relationship between ICD-RSAO and 30-day readmission after ICD implantation.


RESULTS
BUN >30, history of lung disease, NYHA Class IV and device implant during inpatient stay were predicative of 30-day readmission (P = 0.001; 95% CI = 0.58-0.79). Patients with a combination of two or more of four variables were more likely to be readmitted (Hosmer-Lemeshow (χ(2) = 3.44, P = 0.49), c-statistic = 0.71, and Nagelkerke R(2) = 0.15).


CONCLUSIONS
Patients who have elevated BUN's, NYHA Class IV, chronic lung disease and ICD implantation during a concomitant hospital admission are at increased risk for readmission and need early follow up.
Wayne State University, College of Nursing, Detroit, MI, USA. Electronic address: sandraolivermcneil@wayne.edu.
Sandra
S
Oliver-McNeil
Wayne State University, College of Nursing, Detroit, MI, USA.
Thomas N
TN
Templin
Beaumont Health System, Heart Rhythm Center, Royal Oak, MI, USA.
David E
DE
Haines
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012042:Registries; D012307:Risk Factors
Early follow-up; Heart failure; Implantable cardioverter defibrillator; Quality; Readmissions