Thirty‐Day Readmission After Infective Endocarditis: Analysis From a Nationwide Readmission Database. Issue 9 (7th May 2019)

• Record Type: Journal Article
• Authors: Morita, Yusuke; Haruna, Tetsuya; Haruna, Yoshisumi; Nakane, Eisaku; Yamaji, Yuhei; Hayashi, Hideyuki; Hanyu, Michiya; Inoko, Moriaki
• Is Part Of: Journal of the American Heart Association. Volume 8:Issue 9(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-05-07
• Subjects: epidemiology -- infective endocarditis -- readmission -- surgery; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.118.011598
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: The contemporary incidence of and reasons for early readmission after infective endocarditis (IE) are not well known. Therefore, we analyzed 30‐day readmission demographics after IE from the US Nationwide Readmission Database. Methods and Results: We examined the 2010 to 2014 Nationwide Readmission Database to identify index admissions for a primary diagnosis of IE with survival at discharge. Incidence, reasons, and independent predictors of 30‐day unplanned readmissions were analyzed. In total, 11 217 patients (24.8%) were nonelectively readmitted within 30 days among the 45 214 index admissions discharged after IE. The most common causes of readmission were IE (20.5%), sepsis (8.7%), complications of device/graft (8.1%), and congestive heart failure (7.6%). In‐hospital mortality and the valvular surgery rates during the readmissions were 8.1% and 9.1%, respectively. Discharge to home or self‐care, undergoing valvular surgery, aged ≥60 years, and having private insurance were independently associated with lower rates of 30‐day readmission. Length of stay of ≥10 days, congestive heart failure, diabetes mellitus, renal failure, chronic pulmonary disease, peripheral artery disease, and depression were associated with higher risk. The total hospital costs of readmission were $48.7 million per year (median, $11 267; interquartile range, $6021–$25 073), which accounted for 38.6% of the total episodes of care (index+readmission). Conclusions: Almost 1 in 4 patients was readmitted within 30 days of admission for IE. The most common reasons were IE, other infectious causes, and cardiac causes. A multidisciplinary approach to determine the surgical indications and close monitoring are necessary to improve outcomes and reduce complications in in‐hospital and postdischarge settings.