Author + information
- Received April 29, 2011
- Revision received August 4, 2011
- Accepted August 5, 2011
- Published online December 1, 2011.
- Edward L. Hannan, PhD⁎,⁎ (, )
- Ye Zhong, MD⁎,
- Harlan Krumholz, MD¶,
- Gary Walford, MD‡,
- David R. Holmes Jr, MD#,
- Nicholas J. Stamato, MD§,
- Alice K. Jacobs, MD⁎⁎,
- Ferdinand J. Venditti, MD†,
- Samin Sharma, MD∥ and
- Spencer B. King III, MD††
- ↵⁎Reprint requests and correspondence:
Dr. Edward L. Hannan, School of Public Health, State University of New York, University at Albany, One University Place, Rensselaer, New York 12144-3456
Objectives This study sought to report percutaneous coronary intervention (PCI) 30-day readmission rates, identify the impact of staged (planned) readmissions on overall readmission rates, determine the significant predictors of unstaged readmissions after PCI, and specify the reasons for readmissions.
Background Hospital readmissions occur frequently and incur substantial costs. PCI are among the most common and costly procedures, and little is known about the nature and extent of readmissions for PCI.
Methods We retrospectively analyzed 30-day readmissions after PCI using the nation's largest statewide PCI registry to identify 40,093 New York State patients who underwent PCI between January 1, 2007, and November 30, 2007. Demographic variables, pre-procedural risk factors, complications of PCI, and length of stay were considered as potential predictors of readmission, and reasons for readmission were identified from New York's administrative database using principal diagnoses.
Results A total of 15.6% of all PCI patients were readmitted within 30 days, and 20.6% of these readmissions were staged. Among unstaged readmissions, the most common reasons for readmission were chronic ischemic heart disease (22.5%), chest pain (10.8%), and heart failure (8.2%). A total of 2,015 patients (32.2% of readmissions) underwent a repeat PCI. Thirteen demographic and diagnostic risk factors, as well as longer lengths of stay, were all associated with higher readmission rates.
Conclusions Future efforts to reduce readmissions should be directed toward the recognition of patients most at risk, and the reasons they are readmitted. Staging also should be examined from a cost-effectiveness standpoint as a function of patients' unique risk factors.
Dr. Krumholz is a chair for the Cardiac Advisory Board for United Healthcare, and received a research grant from Medtronic, Inc. Dr. Sharma received honorary for speaking engagement for Boston Scientific Corporation, Abbott, Lilly, and The Medicines Co. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Stephen Ellis, MD, served as Guest Editor for this paper.
- Received April 29, 2011.
- Revision received August 4, 2011.
- Accepted August 5, 2011.
- American College of Cardiology Foundation