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Pulmonary arterial hypertension (PAH) is associated with a high risk for adverse outcomes. Recent quality metrics have incorporated 30 day all cause readmission (30dRead) rates; little, however, is known about the frequency and predictors of 30dRead after PAH hospitalization.
We examined 30dRead after discharge for index medical hospitalizations for adults ≥18 years-old with a principal diagnosis of PAH (ICD-9 416.0) using 2003-2006 California Office of Statewide Health Planning and Development data. Hospitals were defined as high (≥20; top tertile) or low (<20) volume based on number of index PAH hospitalizations during the study period. Multivariable logistic regression was performed inclusive of age, sex and univariate predictors of 30dRead.
From 2003 to 2006, there were 704 index PAH hospitalizations; 41 were transferred to another hospital and 9.2% of the remaining 663 died during hospitalization. Of 602 patients discharged, 22.8% were readmitted within 30d. Univariate predictors of 30dRead are shown in the Table. Discharge from a low volume hospital was associated with a greater odds of 30dRead (26.4% v 16.2%, multivariable OR=1.7, 95%CI 1.1-2.6). Low volume hospitals similarly had a higher rate of combined 30dRead or death (33.4% v 21.8%, multivariable OR=1.6, 95%CI 1.1-2.5).
Short-term readmission is common after PAH hospitalization. Patients admitted to high volume PAH hospitals have lower rates of 30 day readmission.
|Length of stay, days||6.5±0.5||5.8±0.3||0.02|
|Number of comorbidities||2.9±0.1||2.2±0.1||0.003|
|Private insurance, %||25.6||38.5||0.009|
|Diabetes mellitus, %||27.7||18.1||0.02|
|Coronary disease, %||19.0||10.8||0.02|
|Heart failure, %||51.1||39.4||0.02|
|Interstitial lung disease, %||10.9||4.5||0.01|
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Pulmonary Hypertension: Epidemiology, Prognosis, Outcomes
Abstract Category: 27. Pulmonary Hypertension
Presentation Number: 1251M-150
- 2013 American College of Cardiology Foundation