Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention

Unplanned readmissions to hospital after percutaneous coronary intervention (PCI) pose a significant burden to the healthcare system and are potentially preventable. In this study, we sought to determine the incidence of, and risk factors for, unplanned hospital readmissions within 30 days following...

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Main Authors: Sinjini Biswas, Diem Dinh, Mark Lucas, Stephen J. Duffy, Angela L. Brennan, Danny Liew, Nicholas Cox, Voltaire Nadurata, Christopher M. Reid, Jeffrey Lefkovits, Dion Stub
Format: Article
Language:English
Published: MDPI AG 2020-10-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/9/10/3242
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spelling doaj-f69130c783654eecaa6a0b6805e9848a2020-11-25T03:43:15ZengMDPI AGJournal of Clinical Medicine2077-03832020-10-0193242324210.3390/jcm9103242Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary InterventionSinjini Biswas0Diem Dinh1Mark Lucas2Stephen J. Duffy3Angela L. Brennan4Danny Liew5Nicholas Cox6Voltaire Nadurata7Christopher M. Reid8Jeffrey Lefkovits9Dion Stub10School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne 3004, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne 3004, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne 3004, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne 3004, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne 3004, AustraliaDepartment of Cardiology, Western Health, Melbourne 3021, AustraliaDepartment of Cardiology, Bendigo Health, Bendigo 3550, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne 3004, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne 3004, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne 3004, AustraliaUnplanned readmissions to hospital after percutaneous coronary intervention (PCI) pose a significant burden to the healthcare system and are potentially preventable. In this study, we sought to determine the incidence of, and risk factors for, unplanned hospital readmissions within 30 days following PCI. We prospectively collected data on 28,488 patients undergoing PCI between 2013 and 2019, who were enrolled in the state-wide multi-centre Victorian Cardiac Outcomes Registry. Patients’ data were then linked to data from the Victorian Department of Health administrative database that records statewide hospital admissions. Disease diagnosis codes were used to identify cause of readmission. Patients who had an unplanned readmission were further divided into those who had a cardiac vs. non-cardiac cause for readmission. Overall, 3059 patients (10.7%) had an unplanned hospital readmission within 30 days of PCI, of which 1848 patients (60.4%) were readmitted for primarily cardiac diagnoses. Independent predictors of both 30-day unplanned cardiac and non-cardiac readmissions post-PCI were female sex, having ≥1 admission in the 12 months prior to PCI, acute coronary syndrome presentation, having any in-hospital complication and being discharged on an oral anticoagulant (all <i>p</i> < 0.05). A stepwise increase in readmission risk was observed with increasing number of admissions from 1 to ≥4 admissions in the 12 months prior to PCI. In conclusion, a substantial proportion of patients undergoing PCI have unexpected readmissions to hospital in the 30 days following PCI. Targeted strategies for patients with risk factors for readmission may be useful to reduce this significant burden to the healthcare system.https://www.mdpi.com/2077-0383/9/10/3242percutaneous coronary interventionreadmissionsoutcomes
collection DOAJ
language English
format Article
sources DOAJ
author Sinjini Biswas
Diem Dinh
Mark Lucas
Stephen J. Duffy
Angela L. Brennan
Danny Liew
Nicholas Cox
Voltaire Nadurata
Christopher M. Reid
Jeffrey Lefkovits
Dion Stub
spellingShingle Sinjini Biswas
Diem Dinh
Mark Lucas
Stephen J. Duffy
Angela L. Brennan
Danny Liew
Nicholas Cox
Voltaire Nadurata
Christopher M. Reid
Jeffrey Lefkovits
Dion Stub
Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention
Journal of Clinical Medicine
percutaneous coronary intervention
readmissions
outcomes
author_facet Sinjini Biswas
Diem Dinh
Mark Lucas
Stephen J. Duffy
Angela L. Brennan
Danny Liew
Nicholas Cox
Voltaire Nadurata
Christopher M. Reid
Jeffrey Lefkovits
Dion Stub
author_sort Sinjini Biswas
title Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention
title_short Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention
title_full Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention
title_fullStr Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention
title_full_unstemmed Incidence and Predictors of Unplanned Hospital Readmission after Percutaneous Coronary Intervention
title_sort incidence and predictors of unplanned hospital readmission after percutaneous coronary intervention
publisher MDPI AG
series Journal of Clinical Medicine
issn 2077-0383
publishDate 2020-10-01
description Unplanned readmissions to hospital after percutaneous coronary intervention (PCI) pose a significant burden to the healthcare system and are potentially preventable. In this study, we sought to determine the incidence of, and risk factors for, unplanned hospital readmissions within 30 days following PCI. We prospectively collected data on 28,488 patients undergoing PCI between 2013 and 2019, who were enrolled in the state-wide multi-centre Victorian Cardiac Outcomes Registry. Patients’ data were then linked to data from the Victorian Department of Health administrative database that records statewide hospital admissions. Disease diagnosis codes were used to identify cause of readmission. Patients who had an unplanned readmission were further divided into those who had a cardiac vs. non-cardiac cause for readmission. Overall, 3059 patients (10.7%) had an unplanned hospital readmission within 30 days of PCI, of which 1848 patients (60.4%) were readmitted for primarily cardiac diagnoses. Independent predictors of both 30-day unplanned cardiac and non-cardiac readmissions post-PCI were female sex, having ≥1 admission in the 12 months prior to PCI, acute coronary syndrome presentation, having any in-hospital complication and being discharged on an oral anticoagulant (all <i>p</i> < 0.05). A stepwise increase in readmission risk was observed with increasing number of admissions from 1 to ≥4 admissions in the 12 months prior to PCI. In conclusion, a substantial proportion of patients undergoing PCI have unexpected readmissions to hospital in the 30 days following PCI. Targeted strategies for patients with risk factors for readmission may be useful to reduce this significant burden to the healthcare system.
topic percutaneous coronary intervention
readmissions
outcomes
url https://www.mdpi.com/2077-0383/9/10/3242
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