F-7 | Thirty Days Readmission Rates and Outcome in Morbidly Obese Patients Undergoing Peripheral Angioplasty and Stenting for Chronic Lower Extremity Peripheral Arterial Diseases

As an expanding field of cardiovascular intervention, there has been substantial data regarding peripheral angioplasty, stenting success, and complication rates. However, there is limited data on the thirty days readmission rates and underlying socio-economic determinants that affect the outcomes of this intervention among the morbidly obese demographic. We queried the National Readmission Database from 2016 to 2020, using the validated International Classification of Diseases (10th Edition) for patients with a body mass index ≥ 40 kg/m2 and a primary diagnosis of lower extremity peripheral arterial diseases (PAD). Exclusion criteria included patients with percutaneous intervention for coronary artery disease and valvular replacement/repair. We assessed the case fatality rate in index admission, readmission rate, etiologies of re-admission, sociodemographic and predictors of re-admission. All these outcomes were stratified by the index year of occurrence. About 12.9% (64,282) of patients with morbid obesity (497,165) who underwent peripheral angioplasty and stenting for chronic lower extremity PAD were readmitted within thirty days of discharge. The major reasons for readmissions were anemia (43.1%), hemodialysis (10.9%), periprocedural complications (4%), and liver disease (3.32%). With stratified Pearson's chi-squared testing, hypertension (7.09, P = 0.001), sepsis (4.70, P = 0.03), deep vein thrombosis (6.22, P = 0.01), mortality (13.67, P = 0.0002), pulmonary embolism (4.86, P = 0.027), and diabetes mellitus (3.85, P = 0.049) were found to be significantly associated with increased risk of readmissions. The sex of the patient and type of admission [elective vs non-elective] showed no significant differences (P>0.05). Our results show that morbid obesity is associated with critical complications that result in rehospitalization following revascularization procedures for chronic lower extremity PAD. Clinicians and prospective studies need to focus on and explore ways to prevent these common reasons for re-admission thirty days after revascularization.