Author + information
- Eric Alexander Secemskya,b,
- Kevin Kennedya,b,
- Marc Schermerhorna,b,
- Bruce Landona,b and
- Robert Yeha,b
Background: Peripheral arterial disease affects over 8.5 million Americans, many of whom undergo invasive vascular procedures. Although limited data suggest high rates of rehospitalization after such procedures, the overall burden has not been comprehensively explored.
Methods: From the Nationwide Readmissions Database, an all-payer database from 21 US states accounting for 49.1% of US hospitalizations, we identified all lower extremity arterial interventions during hospitalizations in 2013 using ICD9 codes, including surgical and endovascular procedures. We examined 30 day readmission rates, diagnoses and costs. Hierarchical logistic regression was used to calculate 30 day risk-standardized readmission rates (RSRR), adjusted for hospital case mix.
Results: In 2013, there were 86,806 admissions with peripheral arterial procedures at 1,110 hospitals. In-hospital death occurred in 3.1% (endovascular: 2.8%; surgical: 3.6%). Among survivors to discharge, the crude 30-day readmission rate was 22.4% (endovascular: 24.0%; surgical: 19.6%). There was little variation in hospital 30-day RSRR (IQR 21.6% – 23.1%), with a median rate ratio for readmissions of 1.10 between 2 randomly selected hospitals. The total cost of all readmissions was $323,001,372. Top causes of readmission are displayed in the Figure.
Conclusions: Nearly 1 in 4 patients who undergo peripheral intervention are readmitted within 30 days. These readmissions are commonly procedural-related and are associated with high costs.
Moderated Poster Contributions
Vascular Medicine Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-3:55 p.m.
Session Title: Optimizing Treatment of Peripheral Artery Disease
Abstract Category: 39. Vascular Medicine: Endovascular Therapy
Presentation Number: 1179M-03
- 2017 American College of Cardiology Foundation