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Trends,Predictors, and Outcomes Associated With 30-Day Hospital Readmissions After Percutaneous Coronary Intervention in a High-Volume Center Predominantly Using Radial Vascular Access
Institution:1. National Heart Centre Singapore, Singapore, Singapore;2. National Registry of Disease Office, Health Promotion Board, Singapore;3. Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, Singapore, Singapore;4. National University Heart Centre, Singapore;5. Tan Tock Seng Hospital, Singapore, Singapore;6. Khoo Teck Puat Hospital, Singapore, Singapore;7. Changi General Hospital, Singapore;8. Norfolk and Norwich University Hospital, Norwich, UK;9. The Hatter Cardiovascular Institute, University College London, London, UK;10. Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan;11. Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore;12. Tecnologico de Monterrey, Centro de Biotecnologia-FEMSA, Nuevo Leon, Mexico
Abstract:Background and aimPatients undergoing percutaneous coronary intervention (PCI) are at high-risk for hospital readmission. We examined the rate, factors associated with, and outcomes of 30-day readmissions for patients who underwent a PCI.MethodsWe reviewed medical records of all patients who underwent PCI between 2011 and 2014 at a central New England radial first, tertiary care center. Data was collected on occurrence and cause of readmission as well as patients' bleeding events and survival at one year. Logistic regression was used to examine factors associated with 30-day readmission as well as its association with bleeding and all-cause mortality.ResultsA total of 3858 patients were studied (mean age = 62.8 years with 26.1% women), among whom 348 (9.5%) patients were readmitted within 30-days. Cardiac causes of readmission represented 62% of all readmissions. In the multi-variable adjusted regression model, factors that were significantly associated with 30-day readmission included female gender, prior coronary bypass surgery, acute coronary syndrome, anemia, length of stay, and delay in initial presentation. Patients who were readmitted had more than twice the risk of bleeding and mortality at one year as compared to those who were not readmitted within 30 days.ConclusionsIn conclusion, our results suggest that early hospital readmission after undergoing PCI is common and has not changed in recent years. Efforts should be made to identify and closely monitor patients who are at risk for readmission after PCI.
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