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Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes Intravenous Statin Administration During Myocardial Infarction Compared With Oral Post-Infarct Administration Coronary CT Angiography and 5-Year Risk of Myocardial Infarction Prevalence of Coronary Vasospasm Using Coronary Reactivity Testing in Patients With Spontaneous Coronary Artery Dissection Pharmacotherapy in the Management of Anxiety and Pain During Acute Coronary Syndromes and the Risk of Developing Symptoms of Posttraumatic Stress Disorder Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation: A Systematic Review and Meta-Analysis Post-Discharge Bleeding and Mortality Following Acute Coronary Syndromes With or Without PCI Transition of Macrophages to Fibroblast-Like Cells in Healing Myocardial Infarction Morphine and Cardiovascular Outcomes Among Patients With Non-ST-Segment Elevation Acute Coronary Syndromes Undergoing Coronary Angiography

Original Research2019 Apr 22;12(8):734-748.

JOURNAL:JACC Cardiovasc Interv. Article Link

Timing and Causes of Unplanned Readmissions After Percutaneous Coronary Intervention: Insights From the Nationwide Readmission Database

Kwok CS, Shah B, Mamas M et al. Keywords: cost; PCI; readmissions

ABSTRACT


OBJECTIVES - The aim of this study was to describe the rates and causes of unplanned readmissions at different time periods following percutaneous coronary intervention (PCI).


BACKGROUND - The rates and causes of readmission at different time periods after PCI remain incompletely elucidated.


METHODS - 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.


RESULTS - 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).


CONCLUSIONS - 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.

Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.