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Effect of comorbidity on unplanned readmissions after percutaneous coronary intervention (from The Nationwide Readmission Database)

Effect of comorbidity on unplanned readmissions after percutaneous coronary intervention (from The Nationwide Readmission Database)
Effect of comorbidity on unplanned readmissions after percutaneous coronary intervention (from The Nationwide Readmission Database)

It is unclear how comorbidity influences rates and causes of unplanned readmissions following percutaneous coronary intervention (PCI). We analyzed patients in the Nationwide Readmission Database who were admitted to hospital between 2010 and 2014. The comorbidity burden as defined by the Charlson Comorbidity Index (CCI). Primary outcomes were 30-day readmission rates and causes of readmission according to comorbidity burden. A total of 2,294,346 PCI procedures were included the analysis. The patients in CCI = 0, 1, 2 and ≥3 were 842,272(36.7%), 701,476(30.6%), 347,537(15.1%) and 403,061(17.6%), respectively. 219,227(9.6%) had an unplanned readmission within 30 days and rates by CCI group were 6.6%, 8.6%, 11.4% and 15.9% for CCI groups 0, 1, 2 and ≥3, respectively. The CCI score was also associated with greater cost (cost of index PCI for not readmitted vs readmitted was CCI = 0 $21,257 vs $19,764 and CCI ≥ 3 $26,736 vs $27,723). Compared to patients with CCI = 0, greater CCI score was associated with greater independent odds of readmission (CCI = 1 OR 1.25(1.22–1.28), p < 0.001, CCI ≥ 3 OR 2.08(2.03–2.14), p < 0.001). Rates of non-cardiac causes for readmissions increased with increasing CCI group from 49.4% in CCI = 0 to 57.1% in CCI ≥ 3. Rates of early unplanned readmission increase with greater comorbidity burden and non-cardiac readmissions are higher among more comorbid patients.

2045-2322
Kwok, Chun Shing
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Martinez, Sara C.
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Pancholy, Samir
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Ahmed, Waqar
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al-Shaibi, Khaled
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Potts, Jessica
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Mohamed, Mohamed
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Kontopantelis, Evangelos
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Curzen, Nick
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Mamas, Mamas A.
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Kwok, Chun Shing
000170fb-8506-4c19-9481-e56d93049fef
Martinez, Sara C.
681b32da-2de5-4553-ba25-10ab0c1e03b4
Pancholy, Samir
5afaaf2f-ed6e-40a9-bbbd-53b16402d6b9
Ahmed, Waqar
cd648e2e-0615-4ceb-8ab8-cc39319600f5
al-Shaibi, Khaled
f6b83249-b266-46da-8fca-18a3db46d9c5
Potts, Jessica
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Mohamed, Mohamed
812754eb-27ff-4151-997e-f17190cc0691
Kontopantelis, Evangelos
0a21ca6f-4516-45f8-80fc-b10dd7db6780
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
Mamas, Mamas A.
b71e6a0a-07a4-4822-a10e-c02a6b29ae5d

Kwok, Chun Shing, Martinez, Sara C., Pancholy, Samir, Ahmed, Waqar, al-Shaibi, Khaled, Potts, Jessica, Mohamed, Mohamed, Kontopantelis, Evangelos, Curzen, Nick and Mamas, Mamas A. (2018) Effect of comorbidity on unplanned readmissions after percutaneous coronary intervention (from The Nationwide Readmission Database). Scientific Reports, 8 (1), [11156]. (doi:10.1038/s41598-018-29303-y).

Record type: Article

Abstract

It is unclear how comorbidity influences rates and causes of unplanned readmissions following percutaneous coronary intervention (PCI). We analyzed patients in the Nationwide Readmission Database who were admitted to hospital between 2010 and 2014. The comorbidity burden as defined by the Charlson Comorbidity Index (CCI). Primary outcomes were 30-day readmission rates and causes of readmission according to comorbidity burden. A total of 2,294,346 PCI procedures were included the analysis. The patients in CCI = 0, 1, 2 and ≥3 were 842,272(36.7%), 701,476(30.6%), 347,537(15.1%) and 403,061(17.6%), respectively. 219,227(9.6%) had an unplanned readmission within 30 days and rates by CCI group were 6.6%, 8.6%, 11.4% and 15.9% for CCI groups 0, 1, 2 and ≥3, respectively. The CCI score was also associated with greater cost (cost of index PCI for not readmitted vs readmitted was CCI = 0 $21,257 vs $19,764 and CCI ≥ 3 $26,736 vs $27,723). Compared to patients with CCI = 0, greater CCI score was associated with greater independent odds of readmission (CCI = 1 OR 1.25(1.22–1.28), p < 0.001, CCI ≥ 3 OR 2.08(2.03–2.14), p < 0.001). Rates of non-cardiac causes for readmissions increased with increasing CCI group from 49.4% in CCI = 0 to 57.1% in CCI ≥ 3. Rates of early unplanned readmission increase with greater comorbidity burden and non-cardiac readmissions are higher among more comorbid patients.

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Accepted/In Press date: 2 July 2018
e-pub ahead of print date: 24 July 2018
Published date: 1 December 2018

Identifiers

Local EPrints ID: 422997
URI: http://eprints.soton.ac.uk/id/eprint/422997
ISSN: 2045-2322
PURE UUID: 61bd1f9c-4f02-4460-a369-43b8f16aff2a
ORCID for Nick Curzen: ORCID iD orcid.org/0000-0001-9651-7829

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Date deposited: 09 Aug 2018 16:30
Last modified: 18 Feb 2021 17:04

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Contributors

Author: Chun Shing Kwok
Author: Sara C. Martinez
Author: Samir Pancholy
Author: Waqar Ahmed
Author: Khaled al-Shaibi
Author: Jessica Potts
Author: Mohamed Mohamed
Author: Evangelos Kontopantelis
Author: Nick Curzen ORCID iD
Author: Mamas A. Mamas

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