Author + information
- Received August 15, 2018
- Revision received January 23, 2019
- Accepted February 5, 2019
- Published online April 15, 2019.
- Chun Shing Kwok, MBBS, MSc, BSca,b,
- Binita Shah, MDc,
- Jassim Al-Suwaidi, MBChBd,
- David L. Fischman, MDe,
- Lene Holmvang, MD, DMScf,
- Chadi Alraies, MDg,
- Rodrigo Bagur, MD, PhDa,
- Vinayak Nagaraja, MBBS, MSa,b,
- Muhammad Rashid, MBBSa,
- Mohamed Mohamed, MBBCha,b,
- Glen P. Martin, PhDh,
- Evan Kontopantelis, PhDh,
- Tim Kinnaird, MDi and
- Mamas Mamas, BM, BCh, MA, DPhila,b,∗ (, )@mmamas1973
- aKeele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom
- bRoyal Stoke University Hospital, Stoke-on-Trent, United Kingdom
- cVA New York Harbor Healthcare System, New York University School of Medicine, New York, New York
- dHeart Hospital, Hamad Medical Corporation and Weill Cornell Medical College, Doha, Qatar
- eThomas Jefferson University Hospital, Philadelphia, Pennsylvania
- fDepartment of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- gWayne State University School of Medicine, Detroit Heart Hospital, Detroit, Michigan
- hDivision of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
- iDepartment of Cardiology, University Hospital of Wales, Cardiff, United Kingdom
- ↵∗Address for correspondence:
Dr. Mamas Mamas, Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent ST5 5BG, United Kingdom.
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.
This study was supported by a grant from the Research and Development Department at the Royal Stoke Hospital. This work is conducted as a part of a PhD for Dr. Kwok, which is supported by Biosensors International. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 15, 2018.
- Revision received January 23, 2019.
- Accepted February 5, 2019.
- 2019 American College of Cardiology Foundation
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