TY - JOUR
T1 - National Landscape of Unplanned 30-Day Readmissions in Patients With Left Ventricular Assist Device Implantation
AU - Patel, Shanti
AU - Poojary, Priti
AU - Pawar, Sumeet
AU - Saha, Aparna
AU - Patel, Achint
AU - Chauhan, Kinsuk
AU - Correa, Ashish
AU - Mondal, Pratik
AU - Mahajan, Kanika
AU - Chan, Lili
AU - Ferrandino, Rocco
AU - Mehta, Dhruv
AU - Agarwal, Shiv Kumar
AU - Annapureddy, Narender
AU - Patel, Jignesh
AU - Saunders, Paul
AU - Crooke, Gregory
AU - Shani, Jacob
AU - Ahmad, Tariq
AU - Desai, Nihar
AU - Nadkarni, Girish N.
AU - Shetty, Vijay
N1 - Funding Information:
Our study population was extracted from the National Readmissions Database (NRD) from the State Inpatient Databases (SID) of the Healthcare Cost and Utilization Project (HCUP), developed through a federal-state-industry partnership sponsored by the Agency for Healthcare Research and Quality. 8 The NRD is a powerful database that includes data from approximately 15 million discharges each year from 21 geographically dispersed states and constructed using reliable, verified patient linkage numbers in the SID that could be used to track the patient across hospitals. These data account for half of the noninstitutionalized U.S. hospitalizations and can be weighted for nationally representative estimates. As our analysis was done on publicly available, de-identified data, the study was considered to be institutional review board exempt.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/7/15
Y1 - 2018/7/15
N2 - The number of patients with advanced heart failure receiving left ventricular assist device (LVAD) implantation has increased dramatically over the last decade. There are limited data available about the nationwide trends of complications leading to readmissions after implantation of contemporary devices. Patients who underwent LVAD implantation from January 2013 to December 2013 were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code 37.66 from the Healthcare Cost and Utilization Project's National Readmission Database. The top causes of unplanned 30-day readmission after LVAD implantation were determined. Survey logistic regression was used to analyze the significant predictors of readmission. In 2013, there were 2,235 patients with an LVAD implantation. Of them, 665 (29.7%) had at least 1 unplanned readmission within 30 days, out of which 289 (43.4%) occurred within 10 days after discharge. Implant complications (14.9%), congestive heart failure (11.7%), and gastrointestinal bleeding (8.4%) were the top 3 diagnoses for the first readmission and accounted for more than a third of all readmissions. Significant predictors of readmissions included a prolonged length of stay during the index admission, Medicare insurance, and discharge to short-term facility. In conclusion, despite increased experience with LVADs, unplanned readmissions within 30 days of implantation remain significantly high.
AB - The number of patients with advanced heart failure receiving left ventricular assist device (LVAD) implantation has increased dramatically over the last decade. There are limited data available about the nationwide trends of complications leading to readmissions after implantation of contemporary devices. Patients who underwent LVAD implantation from January 2013 to December 2013 were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code 37.66 from the Healthcare Cost and Utilization Project's National Readmission Database. The top causes of unplanned 30-day readmission after LVAD implantation were determined. Survey logistic regression was used to analyze the significant predictors of readmission. In 2013, there were 2,235 patients with an LVAD implantation. Of them, 665 (29.7%) had at least 1 unplanned readmission within 30 days, out of which 289 (43.4%) occurred within 10 days after discharge. Implant complications (14.9%), congestive heart failure (11.7%), and gastrointestinal bleeding (8.4%) were the top 3 diagnoses for the first readmission and accounted for more than a third of all readmissions. Significant predictors of readmissions included a prolonged length of stay during the index admission, Medicare insurance, and discharge to short-term facility. In conclusion, despite increased experience with LVADs, unplanned readmissions within 30 days of implantation remain significantly high.
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U2 - 10.1016/j.amjcard.2018.03.363
DO - 10.1016/j.amjcard.2018.03.363
M3 - Article
C2 - 29731116
AN - SCOPUS:85046704203
VL - 122
SP - 261
EP - 267
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 2
ER -