Relation Between Age and Unplanned Readmissions After Percutaneous Coronary Intervention (Findings from the Nationwide Readmission Database))

Chun Shing Kwok, Sunil V. Rao, Ian Gilchrist, Sarah C. Martinez, Fakhr Al Ayoubi, Jessica Potts, Muhammad Rashid, Evangelos Kontopantelis, Phyo K. Myint, Mamas A. Mamas

Research output: Contribution to journalArticle

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Abstract

It is unclear how age affects rates and causes of unplanned early readmissions following percutaneous coronary intervention (PCI). We analyzed patients in the Nationwide Readmission Database in the United States between 2010 and 2014 and examine the impact of age on readmissions after PCI. The primary outcomes were age specific 30-day rates and causes of unplanned readmissions. A total of 2,294,345 procedures were analyzed with a 9.6% unplanned readmission rate within 30 days. Unplanned readmissions were 8.1%, 8.1%, 9.5% and 12.6% for age groups <55, 55-64.9, 65-74.9 and ≥75 years, respectively. With increasing age there was an increase in the rate of non-cardiac causes for readmissions (for ages <55, 55-64.9 and ≥75 years, rates were 54.1%, 54.8%, 56.6% and 57.1% respectively p<0.001). Older age was associated with an increased prevalence of infections (13.9% ≥75 years vs 7.7% <55 years), gastrointestinal disease (11.5% ≥75 years vs 9.5% <55 years) and bleeding (7.4% ≥75 years vs 2.9% <55 years) as causes for non-cardiac readmissions and a reduced prevalence of non-specific chest pain (9.9% ≥75 years vs 31.4% <55 years). For cardiac causes, older age was associated with increased prevalence for readmissions due to heart failure (34.6% ≥75 years vs 11.9% <55 years) but a reduced prevalence of coronary artery disease including angina (25.7% ≥75 years vs 51.3% <55 years). In conclusion, older patients have the highest rates of unplanned 30-day readmissions following PCI, with different causes for readmission compared to younger patients. Interventions designed to reduce readmissions after PCI should be age-specific.
Original languageEnglish
Pages (from-to)220-228
Number of pages9
JournalThe American Journal of Cardiology
Volume122
Issue number2
Early online date12 Apr 2018
DOIs
Publication statusPublished - 15 Jul 2018

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Percutaneous Coronary Intervention
Databases
Gastrointestinal Diseases
Chest Pain
Heart Failure
Arteries
Age Groups
Hemorrhage
Infection

Keywords

  • age
  • percutaneous coronary intervention
  • readmissions
  • Outcomes

Cite this

Relation Between Age and Unplanned Readmissions After Percutaneous Coronary Intervention (Findings from the Nationwide Readmission Database)). / Kwok, Chun Shing; Rao, Sunil V.; Gilchrist, Ian; Martinez, Sarah C.; Ayoubi, Fakhr Al; Potts, Jessica; Rashid, Muhammad; Kontopantelis, Evangelos; Myint, Phyo K.; Mamas, Mamas A.

In: The American Journal of Cardiology, Vol. 122, No. 2, 15.07.2018, p. 220-228.

Research output: Contribution to journalArticle

Kwok, Chun Shing ; Rao, Sunil V. ; Gilchrist, Ian ; Martinez, Sarah C. ; Ayoubi, Fakhr Al ; Potts, Jessica ; Rashid, Muhammad ; Kontopantelis, Evangelos ; Myint, Phyo K. ; Mamas, Mamas A. / Relation Between Age and Unplanned Readmissions After Percutaneous Coronary Intervention (Findings from the Nationwide Readmission Database)). In: The American Journal of Cardiology. 2018 ; Vol. 122, No. 2. pp. 220-228.
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AU - Martinez, Sarah C.

AU - Ayoubi, Fakhr Al

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AU - Myint, Phyo K.

AU - Mamas, Mamas A.

N1 - Acknowledgements: We are grateful to the Healthcare Cost and Utilization Project (HCUP) and the HCUP Data Partners for providing the data used in the analysis. List of Supports/Grants Information: The study was supported by a grant from the Research and Development Department at the Royal Stoke Hospital. This work is conducted as a part of PhD for CSK which is supported by Biosensors International.

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N2 - It is unclear how age affects rates and causes of unplanned early readmissions following percutaneous coronary intervention (PCI). We analyzed patients in the Nationwide Readmission Database in the United States between 2010 and 2014 and examine the impact of age on readmissions after PCI. The primary outcomes were age specific 30-day rates and causes of unplanned readmissions. A total of 2,294,345 procedures were analyzed with a 9.6% unplanned readmission rate within 30 days. Unplanned readmissions were 8.1%, 8.1%, 9.5% and 12.6% for age groups <55, 55-64.9, 65-74.9 and ≥75 years, respectively. With increasing age there was an increase in the rate of non-cardiac causes for readmissions (for ages <55, 55-64.9 and ≥75 years, rates were 54.1%, 54.8%, 56.6% and 57.1% respectively p<0.001). Older age was associated with an increased prevalence of infections (13.9% ≥75 years vs 7.7% <55 years), gastrointestinal disease (11.5% ≥75 years vs 9.5% <55 years) and bleeding (7.4% ≥75 years vs 2.9% <55 years) as causes for non-cardiac readmissions and a reduced prevalence of non-specific chest pain (9.9% ≥75 years vs 31.4% <55 years). For cardiac causes, older age was associated with increased prevalence for readmissions due to heart failure (34.6% ≥75 years vs 11.9% <55 years) but a reduced prevalence of coronary artery disease including angina (25.7% ≥75 years vs 51.3% <55 years). In conclusion, older patients have the highest rates of unplanned 30-day readmissions following PCI, with different causes for readmission compared to younger patients. Interventions designed to reduce readmissions after PCI should be age-specific.

AB - It is unclear how age affects rates and causes of unplanned early readmissions following percutaneous coronary intervention (PCI). We analyzed patients in the Nationwide Readmission Database in the United States between 2010 and 2014 and examine the impact of age on readmissions after PCI. The primary outcomes were age specific 30-day rates and causes of unplanned readmissions. A total of 2,294,345 procedures were analyzed with a 9.6% unplanned readmission rate within 30 days. Unplanned readmissions were 8.1%, 8.1%, 9.5% and 12.6% for age groups <55, 55-64.9, 65-74.9 and ≥75 years, respectively. With increasing age there was an increase in the rate of non-cardiac causes for readmissions (for ages <55, 55-64.9 and ≥75 years, rates were 54.1%, 54.8%, 56.6% and 57.1% respectively p<0.001). Older age was associated with an increased prevalence of infections (13.9% ≥75 years vs 7.7% <55 years), gastrointestinal disease (11.5% ≥75 years vs 9.5% <55 years) and bleeding (7.4% ≥75 years vs 2.9% <55 years) as causes for non-cardiac readmissions and a reduced prevalence of non-specific chest pain (9.9% ≥75 years vs 31.4% <55 years). For cardiac causes, older age was associated with increased prevalence for readmissions due to heart failure (34.6% ≥75 years vs 11.9% <55 years) but a reduced prevalence of coronary artery disease including angina (25.7% ≥75 years vs 51.3% <55 years). In conclusion, older patients have the highest rates of unplanned 30-day readmissions following PCI, with different causes for readmission compared to younger patients. Interventions designed to reduce readmissions after PCI should be age-specific.

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