The Relevance of Readmissions after Common IR Procedures: Readmission Rates and Association with Early Mortality
Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Authors
Sarwar, AmmarZhou, Lujia
Chakrala, Nihara
Brook, Olga R.
Weinstein, Jeffrey L.
Rosen, Max P.
Ahmed, Muneeb
UMass Chan Affiliations
Department of RadiologyDocument Type
Journal ArticlePublication Date
2017-05-01Keywords
Radiology
Metadata
Show full item recordAbstract
PURPOSE: To determine all-cause readmission rates for 12 IR procedures and association of time to readmission with risk-adjusted 90-day mortality. MATERIALS AND METHODS: Patients discharged after 12 inpatient IR procedures at a tertiary-care hospital between June 2008 and May 2013 (N = 4,163) were categorized as no readmission (n = 1,479; 40.5%) or readmission between 0 and 7 (n = 379; 10.4%), 8 and 30 (n = 650; 17.8%), 31 and 60 (n = 378; 10.3%), 61 and 90 (n = 169; 4.6%), or 91 and 180 days (n = 280; 7.7%). Readmission rate >/= 15% was considered high based on published national readmission rates for procedures. Risk-adjusted 90-day mortality for each interval was calculated for transjugular intrahepatic portosystemic shunt (TIPS), transjugular and percutaneous liver biopsy (TJLB, PLB), ports, inferior vena cava (IVC) filter, lower extremity angioplasty (LEA), arteriovenous fistulagrams, vascular embolization (VE), percutaneous cholecystostomy (PC), percutaneous transhepatic biliary drainage (PTBD), primary urinary drainage, and feeding tube placement. Covariates included age, sex, race, insurance status, and Charlson Comorbidity Index. RESULTS: All procedures had high 30-day readmission rates (15%-50.5%). Readmissions were highest for ports (50.5%), TJLB (43.4%), PTBD (38.5%), PC (31.9%), and TIPS (31.3%). Readmissions occurred most frequently 8-30 days after discharge for all procedures except VE (31-60 d; 10.6%), PC (31-60 d; 23.4%), and LEA (91-180 d; 15.1%). On multivariate analysis, 30-day readmissions for LEA (AOR 3.19; 95% CI, 1.2-8.2; P = .02), VE (AOR 10.01; 95% CI, 3.1-32.9; P < .001), IVC filter (AOR 2.98; 95% CI, 1.3-6.9; P = .01), PLB (AOR 2.86; 95% CI, 1.71-4.79; P < .001), and PCN (AOR 3.09; 95% CI, 1.29-7.37; P = .01) were associated with 90-day mortality. CONCLUSIONS: Inpatient IR procedures have high 30-day all-cause readmission rates, which can be associated with increased 90-day mortality. Further evaluation to determine preventable causes for readmission may impact 90-day mortality.Source
J Vasc Interv Radiol. 2017 May;28(5):629-636. doi: 10.1016/j.jvir.2017.01.008. Epub 2017 Mar 11. Link to article on publisher's siteDOI
10.1016/j.jvir.2017.01.008Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48118PubMed ID
28291716Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.jvir.2017.01.008