Key result
Among patients surviving PCI for acute myocardial infarction complicated by cardiogenic shock, 19.4% were readmitted within 30 days, most commonly for cardiac conditions.
Why the study?
Survival after PCI in AMI-CS has increased over the years, but short-term readmission rates in this high-risk population remain unknown.
What is the incidence, etiology, and predictors of 30-day readmission after PCI in AMI-CS?
Observational (n=46,435)
Yes
What is the incidence, etiology, and predictors of 30-day readmission after PCI in AMI-CS?
Nearly one in five patients surviving PCI for AMI-CS are readmitted within 30 days, most commonly for cardiac conditions like heart failure.
Short-term readmission after PCI for AMI-CS merits closer monitoring; observational data leaves open targeted reduction strategies.
Background Survival after percutaneous coronary intervention (PCI) in acute myocardial infarction complicated by cardiogenic shock (AMI‐CS) has increased over the years. Short‐term readmission rates in this high‐risk population remain unknown. Methods We queried the United States (U.S.) Nationwide Readmission Database (NRD) from January 2010 to November 2014 using the International Classification of Diseases‐Ninth edition, Clinical Modification (ICD‐9 CM) codes to identify all patients ≥18 years readmitted within 30 days after surviving an index hospitalization for PCI in AMI‐CS. Incidence, etiologies, and predictors of 30‐day readmission were analyzed. Results Among 46,435 patients who survived to discharge after PCI in AMI‐CS, 9,020 (19.4%) were readmitted within 30 days. Median time to 30‐day readmission was 11 days. Cardiac conditions were the most common causes of readmission (57.8%). Heart failure was the leading readmission diagnosis (24.8%). Private insurance including HMO and self‐pay were predictive of lower 30‐day readmission. Among other covariates, female sex, comorbidities such as heart failure, atrial fibrillation, in‐hospital complications such as major bleeding, sepsis, respiratory complications, AKI requiring dialysis, utilization of mechanical circulatory support (IABP and ECMO) were independently predictive of 30‐day readmission. Trend analysis showed decline in 30‐day readmission rates from 21.9% in 2010 to 17.9% in 2014 (ptrend < 0.001). Conclusion In this large real‐world database, one in five patients receiving PCI in AMI‐CS was readmitted within 30 days after discharge. Cardiac conditions were the most common causes of readmission. Insurance type had significant influence on 30‐day readmission.
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Atti et al. (2019) conducted an observational in Acute myocardial infarction complicated by cardiogenic shock (n=46,435). PCI in acute myocardial infarction complicated by cardiogenic shock was evaluated on 30-day readmission. Among patients surviving PCI for acute myocardial infarction complicated by cardiogenic shock, 19.4% were readmitted within 30 days, most commonly for cardiac conditions.
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