Frequency of 30-Day Readmission and Its Causes After Endovascular Aneurysm Intervention of Abdominal Aortic Aneurysm (from the Nationwide Readmission Database)

Authors

• Varunsiri Atti, Department of Medicine, Michigan State University, East Lansing, Michigan.
• Nikhil Nalluri, Division of cardiovascular diseases, Department of Medicine, Lenox Hill Hospital, New York City, New York.
• Varun Kumar, Division of Cardiovascular diseases, Mount Sinai St Luke's Roosevelt, New York City, New York.Follow
• Rabih Tabet, Department of Medicine, Staten Island University Hospital, Staten Island, New York City, New York.
• Srikanth Yandrapalli, Division of Cardiology, New York Medical College at Westchester Medical Center, Valhalla, New York.
• Sushruth Edla, Division of Cardiovascular diseases, Department of Medicine, St. John Hospital and Medical Center, Detroit, Michigan.
• Avnish Tripathi, Division of Cardiovascular diseases, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
• Nileshkumar J. Patel, Division of Cardiovascular diseases, Icahn School of Medicine at Mt Sinai, New York City, New York.
• Mihir Dave, Division of Cardiovascular diseases, Icahn School of Medicine at Mt Sinai, New York City, New York.
• Wilbert S. Aronow, Division of Cardiology, New York Medical College at Westchester Medical Center, Valhalla, New York.
• Mir B. Basir, Division of Cardiovascular diseases, Henry Ford Health System, Detroit, Michigan.
• Thomas P. Davis, Division of Cardiovascular diseases, Department of Medicine, St. John Hospital and Medical Center, Detroit, Michigan.
• Douglas E. Drachman, Division of Cardiovascular diseases, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
• Deepak L. Bhatt, Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, Massachusetts. Electronic address: dlbhattmd@post.harvard.edu.

Document Type

Article

Abstract

Endovascular aneurysm intervention (EVAI) is one of the most commonly performed vascular interventions for abdominal aortic aneurysm (AAA). Data regarding 30-day readmission rates after EVAI are poorly reported in the literature. We used the United States Nationwide Readmission Database from 2010 to 2014 to identify all patients ≥18 years who were readmitted within 30 days after a hospital discharge for EVAI of the AAA. Incidence, etiologies, predictors of 30-day readmission, and trends of readmission rates were analyzed. In 138,014 patients who survived to discharge after an EVAI procedure for AAA, 14,146 (10.24%) were readmitted within 30 days. Median time to readmission was 11 days. Cardiac causes (16.34%) followed by infections (15.40%) and vascular complications (12.86%) were common etiologies of readmission. Greater patient age, female sex, coexisting co-morbidities such as heart failure, atrial fibrillation, peripheral vascular disease, lung disease, and chronic kidney disease were independent predictors of 30-day readmission. In-hospital complications during an index admission such as major bleeding or vascular complications were also predictive of 30-day readmission. Trend analysis showed a progressive decline in readmission rates from 11.3% in 2010 to 9.6% in 2014 (p <0.0001), 20% lower odds in 2014 compared with 2010 (odds ratio 0.80, 95% confidence interval 0.72 to 0.87, p <0.0001). In this contemporary study of EVAI for AAA, nearly 1 in 10 patients was readmitted within 30 days of discharge after an index admission. Cardiac complications and infections were common causes of readmission within 30 days.

Medical Subject Headings

Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal (surgery); Blood Vessel Prosthesis Implantation (methods); Databases, Factual; Endovascular Procedures (methods); Female; Follow-Up Studies; Humans; Incidence; Male; Patient Readmission (statistics & numerical data); Postoperative Complications (epidemiology, etiology); Postoperative Period; Time Factors; Treatment Outcome; United States (epidemiology)

Publication Date

3-15-2019

Publication Title

The American journal of cardiology

E-ISSN

1879-1913

Volume

123

Issue

6

First Page

986

Last Page

994

PubMed ID

30598244

Digital Object Identifier (DOI)

10.1016/j.amjcard.2018.12.006

Recommended Citation

Atti, Varunsiri; Nalluri, Nikhil; Kumar, Varun; Tabet, Rabih; Yandrapalli, Srikanth; Edla, Sushruth; Tripathi, Avnish; Patel, Nileshkumar J.; Dave, Mihir; Aronow, Wilbert S.; Basir, Mir B.; Davis, Thomas P.; Drachman, Douglas E.; and Bhatt, Deepak L., "Frequency of 30-Day Readmission and Its Causes After Endovascular Aneurysm Intervention of Abdominal Aortic Aneurysm (from the Nationwide Readmission Database)" (2019). Neurology. 2071.
https://scholar.barrowneuro.org/neurology/2071