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https://hdl.handle.net/2440/139691
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Type: | Journal article |
Title: | Thirty-Day Unplanned Readmissions Following Elective and Acute Percutaneous Coronary Intervention |
Author: | Nguyen, M.T. Ali, A. Ngo, L. Ellis, C. Psaltis, P.J. Ranasinghe, I. |
Citation: | Heart Lung and Circulation, 2023; 32(5):619-628 |
Publisher: | Elsevier |
Issue Date: | 2023 |
ISSN: | 1443-9506 1444-2892 |
Statement of Responsibility: | Mau T. Nguyen, Anna Ali, Linh Ngo, Chris Ellis, Peter J. Psaltis, Isuru Ranasinghe |
Abstract: | BACKGROUND: Prior studies have reported a high rate of unplanned readmissions following acute percutaneous coronary intervention (PCI). Data outside the USA comparing 30-day unplanned readmissions following elective PCI to those who undergo acute PCI remain limited. METHODS: Patients who underwent a PCI procedure in Australia and New Zealand between 2010 and 2015 were included. We determined the rates, causes and predictors of 30-day unplanned readmissions, as well as rates of repeat revascularisation procedures, for patients who underwent an elective or acute PCI. Predictors of readmissions were identified using logistic regression. RESULTS: A total of 199,686 PCI encounters were included, of which 74,890 (37.5%) were elective and 124,796 (62.5%) were acute procedures. Overall, 10.6% of patients had at least one unplanned readmission within 30 days of discharge with lower rates following elective PCI (7.0%) compared to acute PCI (12.7%) (p<0.01). Non-specific chest pain was the commonest cause of readmission after elective and acute PCI, accounting for 20.7% and 21.5% of readmission diagnoses, respectively. Readmissions for acute myocardial infarction (13.0% vs 4.6%, p<0.01) and heart failure (6.5% vs 3.3%, p<0.01) were higher following acute PCI compared to elective PCI. Among readmitted patients, 16.7% had a coronary catheterisation, 12.2% had a PCI and 0.7% had coronary artery bypass surgery. Multivariable predictors of 30-day unplanned readmission included female sex and comorbidities such as heart failure, metastatic disease, chronic lung disease and renal failure (p<0.0001 for all). CONCLUSIONS: Unplanned readmissions following elective or acute PCI are high. Clinical and quality-control measures are required to prevent avoidable readmissions in both settings. |
Keywords: | Percutaneous coronary intervention Atherosclerosis Coronary artery disease Readmission Elective |
Rights: | © 2023 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. |
DOI: | 10.1016/j.hlc.2023.02.013 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1161506 |
Published version: | http://dx.doi.org/10.1016/j.hlc.2023.02.013 |
Appears in Collections: | Medicine publications |
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