Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom; Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom.
VA New York Harbor Healthcare System, New York University School of Medicine, New York, New York.
JACC Cardiovasc Interv. 2019 Apr 22;12(8):734-748. doi: 10.1016/j.jcin.2019.02.007. Epub 2019 Mar 27.
The aim of this study was to describe the rates and causes of unplanned readmissions at different time periods following percutaneous coronary intervention (PCI).
The rates and causes of readmission at different time periods after PCI remain incompletely elucidated.
Patients undergoing PCI between 2010 and 2014 in the U.S. Nationwide Readmission Database were evaluated for the rates, causes, predictors, and costs of unplanned readmission between 0 and 7 days, 8 and 30 days, 31 and 90 days, and 91 and 180 days after index discharge.
This analysis included 2,412,000 patients; 2.5% were readmitted between 0 and 7 days, 7.6% between 8 and 30 days, 8.9% between 31 and 90 days, and 8.0% between 91 and 180 days (cumulative rates 2.5%, 9.9%, 18.0%, and 24.8%, respectively). The majority of readmissions during each time period were due to noncardiac causes (53.1% to 59.6%). Nonspecific chest pain was the most common identifiable noncardiac cause for readmission during each time period (14.2% to 22.7% of noncardiac readmissions). Coronary artery disease including angina was the most common cardiac cause for readmission during each time period (37.4% to 39.3% of cardiac readmissions). The second most common cardiac cause for readmission was acute myocardial infarction between 0 and 7 days (27.6% of cardiac readmissions) and heart failure during all subsequent time periods (22.2% to 23.7% of cardiac readmissions).
Approximately 25% of patients following PCI have unplanned readmissions within 6 months. Causes of readmission depend on the timing at which they are assessed, with noncardiovascular causes becoming more important at longer time points.
本研究旨在描述经皮冠状动脉介入治疗（PCI）后不同时间段内计划外再入院的发生率和原因。
PCI 后不同时间段内再入院的发生率和原因仍不完全清楚。
在美国全国再入院数据库中，2010 年至 2014 年间接受 PCI 的患者，评估了索引出院后 0 至 7 天、8 至 30 天、31 至 90 天和 91 至 180 天内计划外再入院的发生率、原因、预测因素和费用。
本分析共纳入 241.2 万名患者；0 至 7 天内再入院率为 2.5%，8 至 30 天内再入院率为 7.6%，31 至 90 天内再入院率为 8.9%，91 至 180 天内再入院率为 8.0%（累积再入院率分别为 2.5%、9.9%、18.0%和 24.8%）。每个时间段内大多数再入院的原因是非心脏原因（53.1%至 59.6%）。非特异性胸痛是每个时间段内再入院最常见的可识别非心脏原因（非心脏再入院的 14.2%至 22.7%）。每个时间段内，冠状动脉疾病（包括心绞痛）是再入院最常见的心脏原因（心脏再入院的 37.4%至 39.3%）。第二个最常见的心脏再入院原因是 PCI 后 0 至 7 天的急性心肌梗死（心脏再入院的 27.6%）和所有后续时间段的心力衰竭（心脏再入院的 22.2%至 23.7%）。
大约 25%的 PCI 后患者在 6 个月内有计划外再入院。再入院的原因取决于评估的时间点，非心血管原因在较长时间点变得更为重要。
