Burden of 30-Day Readmissions After Percutaneous Coronary Intervention in833， 344 Patients in the United States：Predictors， Causes， and Cost经历过美国冠状动脉介入治疗后的30天重读，美国344名患者：预测因子，原因和费用.pdfVIP

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2019-05-23 发布于湖南
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Burden of 30-Day Readmissions After Percutaneous Coronary Intervention in833， 344 Patients in the United States：Predictors， Causes， and Cost经历过美国冠状动脉介入治疗后的30天重读，美国344名患者：预测因子，原因和费用.pdf

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J A C C : C A R D I O V A S C U L A R I N T E R V E N T I O N S V O L . 1 1 , N O . 7 , 2 0 1 8 ª 2 0 1 8 B Y T H E A M E R I C A N C O L L E G E O F C A R D I O L O G Y F O U N D A T I O N P U B L I S H E D B Y E L S E V I E R Burden of 30-Day Readmissions After Percutaneous Coronary Intervention in 833,344 Patients in the United States: Predictors, Causes, and Cost Insights From the Nationwide Readmission Database Chun Shing Kwok, MBBS, MSC, BSC,a,b Sunil V. Rao, MD,c Jessica E. Potts, MSC,a Evangelos Kontopantelis, PHD,d Muhammad Rashid, MBBS,a Tim Kinnaird, MD,e Nick Curzen, BM, PHD,f James Nolan, MD,a,b Rodrigo Bagur, MD, PHD,g Mamas A. Mamas, BMBCH, DPHILa,b ABSTRACT OBJECTIVES This study aimed to examine the 30-day unplanned readmissions rate, predictors of readmission, causes of readmissions, and clinical impact of readmissions after percutaneous coronary intervention (PCI). BACKGROUND Unplanned rehospitalizations following PCI carry signiﬁcant burden to both patients and the local health care economy and are increasingly considered as an indicator of quality of care. METHODS Patients undergoing PCI between 2013 and 2014 in the U.S. Nationwide Readmission Database were included. Incidence, predictors, causes, and cost of 30-day unplanned readmissions were determined. RESULTS A total of 833,344 patients with PCI were included, of whom 77,982 (9.3%) had an unplanned readmission within 30 days. Length of stay for the index PCI was greater (4.7 vs. 3.9 days) and mean total hospital cost ($23,211 vs. $37,524) was higher for patients who were readmitted compared with those not readmitted. The factors strongly independently associated with readmissions were index hospitalization discharge against medical advice (odds ratio [OR]: 1.91; 95% conﬁdence interval [CI]: 1.65 to 2.22), transfer to short-term hospital for inpatient care (OR