Author + information
- Enoch Arhinful,
- Xin Xu,
- Ruth Aguiar,
- James Bowen,
- Angela DiSabatino,
- Michael Stillabower,
- Doralisa Morrone,
- William Weintraub and
- Claudine Jurkovitz
Current evidence suggests prolonged hospitalization for Acute Coronary Syndrome (ACS) in the setting of chronic kidney disease (CKD). What remains unclear is the impact of CKD on 30-day readmission rate for suspected ACS.
All patients who came to the emergency department (ED) from 2004 to 2010 and had cardiac Troponin measurement were included. Poisson regression was used to compare 30-day readmission rates between CKD stages after adjusting for age, gender, race, myocardial infarction, diabetes, hypertension and congestive heart failure at first admission.
Of 85,055 patients studied, 51.2% were admitted as In-patient, 13.3% as Observation and 35.5% were discharged directly from the ED (not admitted). Overall 6.2% were readmitted for suspected ACS within 30 days. The crude 30-day readmission rate was 51.6 per 1,000 person-days for GFR≥60 mL/min/1.73 m2, 96.2 for GFR 30–59, 140.2 for GFR 15–29 and 160.0 for GFR<15. The readmission rates followed the same pattern whether patients were In-patient, Observation or discharged directly from the ED (Figure 1). The adjusted 30-day readmission rate for patients with GFR<15 was almost twice as high as the rate for patients with GFR≥60 [incidence rate ratio (IRR):1.9, 95% CI=1.6–2.2]. The IRRs for patients with GFR 15–29 and 30–59 were respectively 1.6 (1.4–1.8) and 1.2 (1.2–1.3).
Readmission for suspected ACS occurs more often in patients with CKD. Close monitoring may provide opportunities to reduce cost and improve outcomes.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Comorbidity and ACS: COPD, Renal Dysfunction, Diabetes
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1257-186
- 2013 American College of Cardiology Foundation