Timing and Causes of Unplanned Readmissions After Percutaneous Coronary Intervention: Insights From the Nationwide Readmission Database

JACC Cardiovasc Interv. 2019 Apr 22;12(8):734-748. doi: 10.1016/j.jcin.2019.02.007. Epub 2019 Mar 27.

Abstract

Objectives: The aim of this study was to describe the rates and causes of unplanned readmissions at different time periods following percutaneous coronary intervention (PCI).

Background: The rates and causes of readmission at different time periods after PCI remain incompletely elucidated.

Methods: Patients undergoing PCI between 2010 and 2014 in the U.S. Nationwide Readmission Database were evaluated for the rates, causes, predictors, and costs of unplanned readmission between 0 and 7 days, 8 and 30 days, 31 and 90 days, and 91 and 180 days after index discharge.

Results: This analysis included 2,412,000 patients; 2.5% were readmitted between 0 and 7 days, 7.6% between 8 and 30 days, 8.9% between 31 and 90 days, and 8.0% between 91 and 180 days (cumulative rates 2.5%, 9.9%, 18.0%, and 24.8%, respectively). The majority of readmissions during each time period were due to noncardiac causes (53.1% to 59.6%). Nonspecific chest pain was the most common identifiable noncardiac cause for readmission during each time period (14.2% to 22.7% of noncardiac readmissions). Coronary artery disease including angina was the most common cardiac cause for readmission during each time period (37.4% to 39.3% of cardiac readmissions). The second most common cardiac cause for readmission was acute myocardial infarction between 0 and 7 days (27.6% of cardiac readmissions) and heart failure during all subsequent time periods (22.2% to 23.7% of cardiac readmissions).

Conclusions: Approximately 25% of patients following PCI have unplanned readmissions within 6 months. Causes of readmission depend on the timing at which they are assessed, with noncardiovascular causes becoming more important at longer time points.

Keywords: cost; percutaneous coronary intervention; readmissions.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Female
  • Hospital Costs / trends
  • Humans
  • Male
  • Middle Aged
  • Patient Discharge / economics
  • Patient Discharge / trends*
  • Patient Readmission / economics
  • Patient Readmission / trends*
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / economics
  • Percutaneous Coronary Intervention / trends*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • United States