Author + information
- Fabio Lima1,
- Dhaval Kolte2,
- David Louis3,
- Kevin Kennedy4,
- J. Dawn Abbott5,
- Peter Soukas6,
- Omar Hyder3,
- Shafiq Mamdani3 and
- Herbert Aronow7
- 1Brown University/Rhode Island Hospital, Providence, Rhode Island, United States
- 2Brown University, Providence, Rhode Island, United States
- 3Brown University/Rhode Island Hospital, Providence, Rhode Island, United States
- 4University of Missouri Kansas City and Mid America Heart Institute, Kansas City, Missouri, United States
- 5Brown Medical School, Providence, Rhode Island, United States
- 6Cardiovascular Institute, Providence, Rhode Island, United States
- 7Lifespan Cardiovascular Inst, Providence, Rhode Island, United States
An increasing number of patients undergo revascularization for chronic mesenteric ischemia (CMI). However, there are limited contemporary data on the incidence, predictors, and causes of 30-day readmissions following these procedures.
Admissions from the Nationwide Readmissions Database from 2010-2014 with a diagnosis of CMI during which patients underwent endovascular or surgical mesenteric revascularization were included. Rates, reasons and costs of thirty-day readmissions were identified. Hierarchical logistic regression models were used to identify independent predictors of 30-day readmissions.
A nationally weighted cohort of 11,379 patients underwent revascularization for CMI during the study period (mean age 71 years; 70% female; 19% surgery and 81% endovascular). Thirty-day readmission rates were 19.5%. Median time to readmission was 10 (IQR 4,18) days. The top five reasons for readmission included persistent or recurrent manifestations of peripheral/visceral atherosclerosis (11.6%); complications of surgical procedures or medical care (6.0%), septicemia (5.5%), heart failure (5.0%), and gastrointestinal hemorrhage (4.7%). Independent predictors of 30-day readmission appear in the Figure.
Nearly 1-in-5 patients undergoing revascularization for CMI were readmitted within 30-days. Compared with those who underwent endovascular revascularization, patients who underwent surgery were less often readmitted within 30-days. A number of comorbidities, insurance type, and discharge disposition were also independent predictors of 30-day readmission.
ENDOVASCULAR: Peripheral Vascular Disease and Intervention