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Rate, Causes, and Predictors of 30-Day Readmission Following Hospitalization for Acute Pericarditis - 26/11/20

Doi : 10.1016/j.amjmed.2020.05.027 
Jayakumar Sreenivasan, MD, MSc a, , Muhammad Shahzeb Khan, MD b, Urvashi Hooda, MD c, Safi U. Khan, MD d, Wilbert S. Aronow, MD a, Farouk Mookadam, MD e, Richard A. Krasuski, MD f, Howard A. Cooper, MD a, Erin D. Michos, MD, MHS g, Julio A. Panza, MD a
a Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY 
b Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, IL 
c Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY 
d Department of Medicine, West Virginia University, Morgantown 
e Department of Cardiology, Mayo Clinic, Phoenix, Arizona 
f Department of Cardiology, Duke University Medical Center, Durham, NC 
g Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD 

Requests for reprints should be addressed to Jayakumar Sreenivasan, MD, MSc, Department of Cardiology, Westchester Medical Center, 100 Woods Road, Macy Pavilion, Suite 100, Valhalla, NY, 10595.Department of CardiologyWestchester Medical Center100 Woods Road, Macy Pavilion, Suite 100ValhallaNY10595

Abstract

Background

Acute pericarditis is a frequent cause of hospitalization in the United States. Although recurrence of this condition is common, few studies have investigated hospital readmissions in this patient population.

Methods

We queried the National Readmission Database for the years 2016 and 2017 to identify adult admissions for acute pericarditis, and analyzed the data for 30-day readmission. Using multivariate Cox regression analysis, we identified clinical characteristics that were independently predictive of hospital readmission within 30 days.

Results

A total of 21,335 patients (mean age 52.5 ± 0.2 years; 38.3% women) who were discharged following hospitalization for acute pericarditis were included. The rate of 30-day readmission was 12.9% (n = 2740). Increasing age (adjusted hazard ratio [HR] 1.05 per 5-year increase; 95% confidence interval [CI], 1.02-1.09; P < 0.001), female sex (adjusted HR 1.33; 95% CI, 1.18-1.49; P < 0.001), dialysis dependence (adjusted HR 1.70; 95% CI, 1.30-2.22; P < 0.001), chronic obstructive pulmonary disease (adjusted HR 1.27; 95% CI, 1.11–1.45; P < 0.001), and presence of pericardial effusion (adjusted HR 1.24; 95% CI, 1.04-1.49; P = 0.02) were independently associated with a higher risk of readmission. In-hospital mortality was significantly higher after readmission than for the index hospitalization (3.4% vs 1.0%, P < 0.001).

Conclusion

After hospitalization for acute pericarditis, readmission within 30 days is common and is associated with increased mortality. Identification of characteristics associated with a higher risk of readmission may lead to focused interventions to improve outcomes.

Le texte complet de cet article est disponible en PDF.

Keywords : Acute pericarditis, Outcomes, Readmission


Plan


 Funding: None.
 Conflict of Interest: None.
 Authorship: JS: Conceptualization, validation, formal analysis, data curation, writing—original draft, writing—review and editing; MSK: Conceptualization, writing—original draft, resources; UH: Validation, formal analysis, data curation, visualization; SUK: Writing—review and editing, resources, formal analysis; WSA: Validation, writing—review and editing; FM: Writing—review and editing; RAK: Conceptualization, writing—review and editing; HAC: Conceptualization, writing—review and editing; EDM: Writing—review and editing, supervision; JAP: Conceptualization, writing—review and editing, supervision.


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Vol 133 - N° 12

P. 1453 - décembre 2020 Retour au numéro
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