Readmissions to Hospital After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Factors Associated with Readmissions. [Review]

MedStar author(s):
Citation: Cardiovascular Revascularization Medicine. 21(3):375-391, 2020 Mar.PMID: 31196797Institution: MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2020Local holdings: Available in print through MWHC library: 2002 - presentISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: BACKGROUND: Readmissions after PCI are a burden to patients and health services that are not well understood.CONCLUSIONS: We estimate that 1 in 7 patients who undergo PCI are readmitted within 30-days and the rate can rise to up to 3 in 4 patients beyond 3years. Interventions should be considered to reduce readmissions such as discharge checklists, evaluation of medication compliance at follow-up and prompt management when patients re-present to emergency department. Copyright (c) 2019 Elsevier Inc. All rights reserved.METHODS: A systematic review was performed to identify studies of readmission after PCI. Readmission rates and causes of readmission were examined and factors associated with 30-day readmissions were combined using meta-analyses.RESULTS: A total of 39 studies evaluated readmissions after PCI (6,569,690 patients, 31 studies). The 30-day readmission rate varied from 3.3%-15.8%. Beyond 30-days, the readmission rate was 6% at 2months, 31.5% at 6months, 18.6-50.4% at 12months and 26.3-71% beyond 48months. The pooled proportion of patients with cardiac cause for readmissions ranged from 4.6%-75.3%. The range of rates of 30-day readmissions for reinfarction/stent thrombosis, heart failure, chest pain and bleeding were 2.5%-9.5%, 5.9%-12%, 6.7-38.1% and 0.7-7.5%, respectively. Meta-analysis suggests that female gender (RR 1.25(1.20-1.30), I2=65.2%), diabetes (RR 1.22(1.20-1.25), I2=0%), heart failure (RR 1.43(CI 1.28-1.60), I2=92.8%), renal failure (RR 1.50(1.45-1.55), I2=0%), chronic lung disease (RR 1.34(1.26-1.44), I2=87.5%), peripheral artery disease (RR 1.20(1.15-1.25), I2=46.5%) and cancer (RR 1.35(1.15-1.58), I2=72.8%) were associated with 30-day readmissions. The average cost of unplanned and all 30-day readmissions has been reported to be All authors: Alraies MC, Holroyd EW, Kwok CS, Lo TS, Mamas MA, Narain A, Nolan J, Pacha HMFiscal year: FY2020Digital Object Identifier: Date added to catalog: 2020-07-09
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 31196797 Available 31196797

Available in print through MWHC library: 2002 - present

BACKGROUND: Readmissions after PCI are a burden to patients and health services that are not well understood.

CONCLUSIONS: We estimate that 1 in 7 patients who undergo PCI are readmitted within 30-days and the rate can rise to up to 3 in 4 patients beyond 3years. Interventions should be considered to reduce readmissions such as discharge checklists, evaluation of medication compliance at follow-up and prompt management when patients re-present to emergency department. Copyright (c) 2019 Elsevier Inc. All rights reserved.

METHODS: A systematic review was performed to identify studies of readmission after PCI. Readmission rates and causes of readmission were examined and factors associated with 30-day readmissions were combined using meta-analyses.

RESULTS: A total of 39 studies evaluated readmissions after PCI (6,569,690 patients, 31 studies). The 30-day readmission rate varied from 3.3%-15.8%. Beyond 30-days, the readmission rate was 6% at 2months, 31.5% at 6months, 18.6-50.4% at 12months and 26.3-71% beyond 48months. The pooled proportion of patients with cardiac cause for readmissions ranged from 4.6%-75.3%. The range of rates of 30-day readmissions for reinfarction/stent thrombosis, heart failure, chest pain and bleeding were 2.5%-9.5%, 5.9%-12%, 6.7-38.1% and 0.7-7.5%, respectively. Meta-analysis suggests that female gender (RR 1.25(1.20-1.30), I2=65.2%), diabetes (RR 1.22(1.20-1.25), I2=0%), heart failure (RR 1.43(CI 1.28-1.60), I2=92.8%), renal failure (RR 1.50(1.45-1.55), I2=0%), chronic lung disease (RR 1.34(1.26-1.44), I2=87.5%), peripheral artery disease (RR 1.20(1.15-1.25), I2=46.5%) and cancer (RR 1.35(1.15-1.58), I2=72.8%) were associated with 30-day readmissions. The average cost of unplanned and all 30-day readmissions has been reported to be 2,636 and 7,576, respectively.

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