Risk Factors for Hospital Readmission After Percutaneous Coronary Intervention
Background:
Readmission after PCI is a quality metric used as a marker of clinical outcomes and therefore, identifying the risk factors that are associated with increased readmissions post-PCI would be the first step to understanding how readmission rates can be improved after PCI
Methods:
We retrospectively reviewed charts of 191 patients at Hahnemann University Hospital who had PCI for NSTEMI/STEMI and placed patients into two groups: group A consisting of patients who were not readmitted and group B consisting of patients who were readmitted. The two groups were compared and analyzed by chi-square, 2-sample T-test, and odds ratio with confidence intervals
Results:
Baseline demographics between the two patient population were similar. Length of stay was longer in the patient population that was readmitted. The risk factors that are statistically significant between the two groups are the following: history of psychiatric disorder, heart failure, diabetes type 2(DM Type 2), current insulin use, previous stent placements, positive smoking and/or illicit drug use, elevated peak troponin and creatinine levels, and absence of medication compliance.
Conclusions:
Understanding the risk factors that are associated with readmission post-PCI can help us focus on lowering readmission rates post-PCI, such as closer attention to volume status and the utility of echocardiogram follow ups after PCI especially in patients with heart failure. In patients with DM type 2, there has been recent literature on medications that have been shown to have cardiovascular mortalities and there may be utility in placing patients on these drugs prior to discharge. There can also be a stronger outreach for patients with psychiatric disorders and tobacco/illicit drug use disorder. Although this is a single centered retrospective study, we strongly believe the multiple variables elicited in our study will lead to better post-PCI patient care and lower hospital readmissions.