Abstract 17901: Women, Depression & Chronic Kidney Disease Are Associated With Higher Readmissions Following Pulmonary Vein Isolation for Atrial Fibrillation: A Retrospective Cohort Study
Introduction: There is lack of data in identifying factors associated with readmissions following pulmonary vein isolation (PVI) from community hospitals.
Hypothesis: We examined the hypothesis that women and comorbidities are associated with higher 30 and 90 days readmissions following PVI.
Methods: We examined electronic health records of all adult patients (≥ 18 years) who underwent first PVI at a community hospital in Fargo, North Dakota between January 1, 2013 and January 1, 2016. Primary outcome variable was all cause readmissions. We used univariate and multivariate logistic regression model to estimate the associations between demographics, comorbidities, CHADS2 scores, and hospital readmissions. Significant variables on univariate analysis with P values < 0.1 were introduced into multivariate logistic regression model, in which P values <0.05 were considered significant.
Results: A total of 476 patients met the inclusion criteria, 153 (32%) women, mean age was 61.9 years (SEM ± 0.52) and 457 (96%) were Caucasians. As compared to men, women were older (64.9 ± 10.3 vs 60.6 ± 11.5), had higher comorbid burden of cerebrovascular diseases (11.8% vs 5.6%), valvular heart diseases (35.9% vs 21.7%), depression (30.7% vs 17.3%) and lung diseases (25.7% vs 13%), whereas men had higher coronary artery disease (30% vs 15.7%), all P < 0.05. By 30 days, readmissions rate was 11%, which increased to 14% by 90 days. Any dysrhythmia (5.5%, 7.8%), atrial fibrillation (4.7%, 5.9%), and congestive heart failure (1.5%, 1.9%) were most common causes of readmission at 30 and 90 days respectively. On univariate analysis, chronic kidney disease (CKD), valvular heart disease and depession, and CKD, women, and diabetes mellitus were associated with readmissions at 30 and 90 days respectively. In multivariate logistic regression analysis, depression (Odds ratio [OR] 2.17, 95% confidence interval [CI] 1.14 - 4.01) and CKD (OR 2.56, 95% CI 1.03 -5.83) were associated with increased odds of readmissions at 30 days, and women (OR 1.71, 95% CI 1.00 - 2.89) and CKD (OR 2.40, 95% CI 1.04 -5.22) were associated with increased odds of readmissions at 90 days.
Conclusions: This study suggests that women, depression and CKD are associated with increased odds of readmissions following PVI.
Author Disclosures: A. Patel: None. B. Singh: None. W. Newman: None. S. Farkas: None.
- © 2016 by American Heart Association, Inc.