title: Demographic parameters related to 30-day readmission of patients with pulmonary embolism: Analysis of 650,819 hospitalizations.
abstract: BACKGROUND
  Pulmonary embolism (PE) is a serious medical condition associated with major morbidity, mortality and economic burden. Preventable hospital readmissions are a major economic challenge for the healthcare organizations and identifying patient subsets at risk of readmission will help report the issue. This retrospective study was performed to determine demographic parameters and major diagnosis linked with 30day readmission after a PE.
  
  
  METHODS
  Nationwide Inpatient Sample (NIS) data was used to extract data of patients discharged after PE during index admission for years 2009-2013. Patients were identified by Diagnosis Related Group (DRG) number 175 and 176 which represents PE with major complications and comorbidities (MCC) and PE without MCC. Demographic parameters associated with high readmission rate were identified along with causes related to readmissions.
  
  
  RESULTS
  We identified a total of 650,819 hospitalizations with PE as the index stay DRG of which 13.44% were readmitted within 30 days after hospitalizations. Patients with age >65years (14.05%), female (13.87%), Medicaid insurances (20.49%), low median income for zip code (15.1%) and metropolitan areas (13.71%) were associated with higher 30day readmission rates. The most common identified cause of readmission in PE with MCC from 2009 to 2010 was heart failure (4.25%) and from 2011 to 2013 was severe sepsis (4.8%) while for PE without MCC from 2009 to 2013 was PE without MCC itself (10.24%).
  
  
  CONCLUSIONS
  Interventions need to be directed against these set of patients and the identified causes of readmissions to reduce the rehospitalisations from PE.
authors.affiliation: Department of Internal Medicine & Pediatrics/Internal Medicine, Western Michigan University Homer Stryker School of Medicine, Kalamazoo 49008, MI, USA. Electronic address: yashwantagrawal.agrawal@gmail.com.
authors.forename: Yashwant
authors.initials: Y
authors.lastname: Agrawal
authors.affiliation: Department of Internal Medicine & Pediatrics/Internal Medicine, Western Michigan University Homer Stryker School of Medicine, Kalamazoo 49008, MI, USA.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Patri
authors.affiliation: Department of Internal Medicine & Pediatrics/Internal Medicine, Western Michigan University Homer Stryker School of Medicine, Kalamazoo 49008, MI, USA.
authors.forename: Hardik
authors.initials: H
authors.lastname: Chhatrala
authors.affiliation: Mother Theresa Post Graduate and Research Institute Of Health Sciences, Puducherry 605006, India.
authors.forename: Soji
authors.initials: S
authors.lastname: Joseph
authors.affiliation: Department of Interventional Cardiology, Borgess Medical Center/Michigan State University, Kalamazoo, MI, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Saltiel
authors.affiliation: Department of Interventional Cardiology, Borgess Medical Center/Michigan State University, Kalamazoo, MI, USA.
authors.forename: Jagadeesh K
authors.initials: JK
authors.lastname: Kalavakunta
authors.affiliation: Department of Interventional Cardiology, Borgess Medical Center/Michigan State University, Kalamazoo, MI, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Gupta
mesh_terms: D000368:Aged; D015897:Comorbidity; D017281:Cost of Illness; D003710:Demography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000191:economics / Q000706:statistics & numerical data; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: Demographics; Pulmonary embolism; Readmission