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Relation Between Age and Unplanned Readmissions After Percutaneous Coronary Intervention (Findings from the Nationwide Readmission Database) - 30/06/18

Doi : 10.1016/j.amjcard.2018.03.367 
Chun Shing Kwok, MBBS, MSc a, b, * , Sunil V. Rao, MD c, Ian Gilchrist, MD d, Sara C. Martinez, MD, PhD e, Fakhr Al Ayoubi, MSc, RPharm, MBA f, Jessica Potts, MSc a, Muhammad Rashid, MBBS a, Evangelos Kontopantelis, PhD g, Phyo K. Myint, MD h, Mamas A. Mamas, BM, BCh, DPhil a, b
a Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom 
b Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom 
c Department of Cardiology, Duke Clinical Research Institute, Durham, North Carolina 
d Division of Interventional Cardiology, Penn State Heart and Vascular Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania 
e Division of Cardiology, Providence St. Peter Hospital, Olympia, Washington 
f Department of Cardiac Sciences KFCC, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia 
g Faculty of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom 
h Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom 

*Corresponding author: Tel: +44 (0)1782 671653; fax: +44 (0)1782 674467.

Abstract

It is unclear how age affects rates and causes of unplanned early readmissions after percutaneous coronary intervention (PCI). We analyzed patients in the Nationwide Readmission Database in the United States from 2010 to 2014 and examined 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, 55.0 to 64.9, 65.0–74.9, and ≥75 years, respectively. With increasing age, there was an increase in the rate of noncardiac causes for readmissions (for ages <55, 55.0 to 64.9, and ≥75 years, the 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 noncardiac readmissions and a reduced prevalence of nonspecific 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 after PCI, with different causes for readmission compared with younger patients. Interventions designed to reduce readmissions after PCI should be age specific.

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 See page 227 for disclosure information.
 The study was supported by a grant from the Research and Development Department of 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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Vol 122 - N° 2

P. 220-228 - luglio 2018 Ritorno al numero
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