Kwok Chun Shing, Chatterjee Saurav, Bagur Rodrigo, Sharma Kamal, Alraies M Chadi, Fischman David, Savage Michael, Mohamed Mohamed, Shoaib Ahmad, Patel Tejas, Mamas Mamas A
Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK.
Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK.
Catheter Cardiovasc Interv. 2021 Feb 15;97(3):395-408. doi: 10.1002/ccd.28797. Epub 2020 Feb 28.
This study aims to describe temporal trends, characteristics, and clinical outcomes of patients with more than one unplanned readmission within 30 and 180 days after admission with percutaneous coronary intervention (PCI).
There is limited understanding of multiple readmissions after PCI.
Patients undergoing PCI between 2010 and 2014 in the U.S. Nationwide Readmission Database were evaluated for unplanned readmissions at 30 and 180 days after discharge. Trends in multiple readmissions, characteristics of patients, and causes of first readmissions are described.
A total of 2,324,194 patients were included in the analysis of 30-day unplanned readmissions and 1,327,799 patients in the analysis of 180-day unplanned readmission. The proportions of patients with a single readmission and multiple readmissions within 30 days were 8.5 and 1.0% and at 180 days were 15.4 and 9.1%, respectively. Common reasons for first readmission among patients with multiple readmissions were coronary artery disease, including angina, heart failure, and acute myocardial infarction. Factors associated with multiple readmissions were discharge against medical advice, discharge to care home, renal failure, and liver failure. The total cost of multiple readmissions is significant, with an increase from ~$20,000 for no readmission to over $60,000 at 30-day follow up and $86,000 at 180-day follow up.
Multiple readmissions are rare within 30 days after PCI but increase to nearly 1 in 10 patients at 180 days, and 20-25% of patients who have multiple readmissions are readmitted for the same cause as for the first and second readmissions.
本研究旨在描述经皮冠状动脉介入治疗（PCI）术后30天和180天内多次非计划再入院患者的时间趋势、特征及临床结局。
对PCI术后多次再入院的了解有限。
对2010年至2014年在美国全国再入院数据库中接受PCI治疗的患者出院后30天和180天的非计划再入院情况进行评估。描述多次再入院的趋势、患者特征及首次再入院原因。
共有2324194例患者纳入30天非计划再入院分析，1327799例患者纳入180天非计划再入院分析。30天内单次再入院和多次再入院患者的比例分别为8.5%和1.0%，180天分别为15.4%和9.1%。多次再入院患者首次再入院的常见原因是冠状动脉疾病，包括心绞痛、心力衰竭和急性心肌梗死。与多次再入院相关的因素有违反医嘱出院、转至疗养院、肾衰竭和肝衰竭。多次再入院的总成本很高，从无再入院时的约20000美元增加到30天随访时的超过60000美元和180天随访时的86000美元。
PCI术后30天内多次再入院很少见，但180天时增加到近十分之一的患者，且20%-25%多次再入院的患者因与首次和第二次再入院相同的原因再次入院。
