Abstract 14335: Predictors of Hospital Readmission in Patients With Critical Limb Ischemia Treated With Endovascular Therapy
Introduction: Patients with critical limb ischemia (CLI) are at high risk for hospital readmission after endovascular therapy. Identifying predictors of readmission and understanding the prognosis of patients readmitted may improve outcomes.
Methods: In this prospective study of 252 patients with CLI after endovascular therapy, predictors of readmission were determined by Cox proportional hazards analysis. Readmission was stratified by wound status (no wound, wound present but healed by readmission, and persistent wound). The incidence of major adverse limb events (MALE; major amputation, endartectomy, or surgical bypass) was compared in patients readmitted and not readmitted via Kaplan-Meier analysis.
Results: During a median follow-up of 381 days (interquartile range [IQR], 115-718 days), 140 (56%) patients were readmitted. Median days to readmission was 83 (IQR 33-190 days). Independent predictors of readmission are shown in the Table. When analyzed as a time-dependent covariate, wound healing was associated with less risk of readmission (Hazard Ratio 0.39; 95% Confidence Interval 0.22-0.68; p<0.001). Readmission was most frequent in patients with unhealed wounds, and those with healed wounds were less likely to be readmitted than those without wounds (Figure A). MALE was more common in patients readmitted (Figure B).
Conclusions: Patients with CLI and unhealed wounds are at increased risk of readmission after endovascular therapy. Other independent predictors of readmission include presence of multiple wounds, age ≥ 70 years, male gender, history of heart failure, dialysis dependence, and lack of aspirin use. Readmission is associated with increased MALE.
Author Disclosures: P. Raeisi-Giglou: None. G.W. Reed: None. N. Salehi: None. U. Malik: None. R. Kafa: None. M. Maier: None. M.H. Shishehbor: None.
- © 2015 by American Heart Association, Inc.