Abstract 15924: Risk Factors of 30-Day Readmission for Patients Undergoing Revascularization
Background: Hospital readmissions in a 30-day period after the index hospitalization are a costly health care issue. Using data from the Society of Thoracic Surgeons (STS) Database and the American College of Cardiology Foundation (ACCF) National Cardiovascular Data Registry (NCDR) in ASCERT, we examined the risk factors for 30-day readmission of coronary-artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI).
Methods: The STS Database and ACCF NCDR were linked to the Centers for Medicare and Medicaid Services claims data from years 2004 to 2008 for patients who were age ≥65 years with stable 2 and 3-vessel disease undergoing revascularization. The risk factors for 30-day readmission for CABG and PCI patients were examined. Results were adjusted by inverse probability weighting to reduce treatment selection bias.
Results: By 30 days 6,542 (7.6%) of 86,244 in CABG group and 10639 (10.3%) of 103,549 in PCI group were readmitted. Of those, 1684(25.7%) were diagnosed with congestive heart failure (CHF) in CABG; among PCI patients, 1878 (16.6%) and 2050 (19.3%) were readmitted for additional PCI with and without drug eluting stent, respectively. We found that gender, prior MI, CHF, chronic lung disease, and length of stay during the index hospital were significantly associated with readmissions for both groups; number of diseased vessels (3 vs 2) was associated with readmission in PCI group, but not in CABG group; advanced age, cerebrovascular, peripheral vascular disease, and procedure hospital type (teaching vs non-teaching) were associated with readmissions in CABG group, but not in PCI group. Adjusted by other risk factors, readmission was more likely after PCI (odds ratio: 1.58, 95% CI: 1.49 to 1.68).
Conclusions: Risk factors and reasons for 30-day readmission differed and there was significant difference in readmission rates between PCI and CABG patients. Staged procedures will be further examined to reveal the nature of 30-day readmission between two groups.
- Coronary artery disease
- Percutaneous coronary intervention
- Risk factors
- Coronary heart disease
- Congenital heart disease
- © 2013 by American Heart Association, Inc.