Prognostic Significance of Early Rehospitalization After Takotsubo Cardiomyopathy.
Short-term complications, particularly rehospitalization, after a diagnosis of takotsubo cardiomyopathy (TTC) are poorly described. We sought to characterize the rates, causes, clinical associations, and prognostic implications of early rehospitalization in this patient population. We performed a retrospective observational study of all adult subjects diagnosed with TTC at an academic tertiary care hospital from 2005 to 2015. The primary outcome was rehospitalization within 30 days of index discharge. Multivariable logistic regression was used to test for association between clinical variables and rehospitalization. Association between rehospitalization and survival after index discharge was assessed as a secondary outcome using a multivariable Cox proportional hazard model. Two hundred sixty-three subjects met the inclusion criteria for the study. There were 38 rehospitalizations among 32 subjects (12%). Ninety-five percent of rehospitalizations were due to nonheart failure causes, and 76% were related to noncardiovascular complaints. In multivariable analysis, recent hospitalization before TTC diagnosis and increased length of index hospitalization were associated with greater risk of rehospitalization (odds ratio 4.58, 95% CI 1.97 to 10.65, p <0.001 and odds ratio 1.05, 95% CI 1.01 to 1.10, p = 0.026, respectively). Early rehospitalization after TTC was associated with decreased survival (hazard ratio 3.17, 95% CI 1.53 to 6.56, p = 0.002).
University of California Los Angeles, Los Angeles, California. Electronic address: Anayeri@mednet.ucla.edu.
Arash
A
Nayeri
Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Nirmanmoh
N
Bhatia
Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Meng
M
Xu
Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Eric
E
Farber-Eger
Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Marcia
M
Blair
Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
John
J
McPherson
Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Thomas
T
Wang
Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Quinn
Q
Wells
D000368:Aged; D017023:Coronary Angiography; D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000639:trends*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D013997:Time Factors; D014481:United States / Q000453:epidemiology