High Readmission Rates for Critical Limb Ischemia
Predictors of unplanned readmission include age, female sex, black/Hispanic race, prior amputation
FRIDAY, April 14, 2017 (HealthDay News) -- Patients with critical limb ischemia (CLI) have a high risk of readmission, with most of the readmissions unplanned, according to a study published in the April 18 issue of the Journal of the American College of Cardiology.
Shikhar Agarwal, M.D., M.P.H., from Geisinger Medical Center in Danville, Pa., and colleagues examined the incidence of readmission among adults with CLI. Data were included for 695,782 admissions from 212,241 patients.
The researchers found that 284,189 of the admissions were primary CLI admissions. At 30 days and six months, all-cause readmission rates were 27.1 and 56.6 percent, respectively; most readmissions were unplanned. The rates of unplanned readmissions were 23.6 and 47.7 percent, respectively, at 30 days and six months. Age, female sex, black/Hispanic race, prior amputation, Charlson comorbidity index, and need for home health care or rehabilitation facility on discharge were major predictors of six-month unplanned readmissions. Compared with patients with Medicaid/no insurance and Medicare populations, those covered by private insurance were least likely to have a readmission. There was an inverse association for travel time to the hospital with six-month unplanned readmission rates, which was seen in all subgroups. There was a direct association for length of stay during index hospitalization with odds of six-month unplanned readmission (odds ratio, 2.39).
"The readmission rate at 30 days and six months was high in CLI patients, the majority representing unplanned readmissions," the authors write.