Abstract 18030: Prevalence Predictors and Clinical Implications of 90-Day Readmission for Patients With Critical Limb Ischemia
Introduction: Critical limb ischemia (CLI) represents an advanced stage of Peripheral arterial disease with significant attendant morbidity and mortality and it often requires hospitalization. This study was designed to study the prevalence, predictors and outcomes of 90-day readmission in CLI patients.
Methods: We did a secondary analysis of the Nationwide Readmissions Database (NRD) for the year 2013. We included all patients with a primary diagnosis of extremity rest pain, ulceration and tissue necrosis secondary to peripheral arterial disease (PAD) who presented to the hospital in the first three quarters of 2013. From this group, all patients readmitted with similar diagnosis within 90 days were recorded.
Results: From estimated 126,534 patients hospitalized with primary diagnosis of CLI, 15,546 were readmitted for CLI again within 90 days (readmission rate of 12.5%). Mean time to readmission was 38.3±23.5 days. Men had slightly higher rate of readmission than women (12.6% vs 11.8%, P<0.01) and there was no statistically significant difference in readmission rate between different age groups.
Patients underwent surgical revascularization at first presentation had lower rate of readmission in comparison to percutaneous intervention (8.3% vs 16.1%, P <0.001). Table-1 shows the 90 -day readmission rate per therapeutic modality. Further, readmitted patients had a significantly higher amputation and lower revascularization rate compared to the primary admission (22.9% vs. 10.9%, P<0.001; 52.0% vs 31.8%, P <0.001, respectively).
Conclusion: Our study demonstrates that 90-day readmission for CLI is common (12.5%), and it is seen more often in those undergoing percutaneous rather than surgical revascularization. Also, readmission was associated with a significantly higher rate of amputation. Further research is needed to elucidate the reasons behind these findings.
Author Disclosures: R. Masoomi: None. J. Cho: None. K. Hance: None. Z. Shah: None. B. Dawn: None. K. Gupta: None.
- © 2016 by American Heart Association, Inc.