Critical Limb Ischemia Linked to High Rates of Unplanned Hospital Readmission

HealthDay News — For patients with critical limb ischemia (CLI), readmission is high, with most readmissions unplanned, according to a study published online in the Journal of the American College of Cardiology. The research will also be presented at the upcoming annual meeting of the American College of Cardiology, to be held from March 17 to 19 in Washington, DC.

Shikhar Agarwal, MD, MPH, from the Geisinger Medical Center in Danville, Pa., and colleagues analyzed data for all adult hospitalizations with a diagnosis code for CLI from State Inpatient Databases from Florida (2009-2013), New York (2010-2013), and California (2009-2011). A total of 695,782 admissions from 212,241 patients were analyzed, of which 284,189 were primary CLI admissions.

The researchers found that at 30 days and 6 months the all-cause readmission rates were 27.1% and 56.6%, respectively. Most readmissions were unplanned; at 30 days and 6 months, unplanned readmission rates were 23.6% and 47.7%, respectively. Age, female gender, black/Hispanic race, prior amputation, Charlson comorbidity index, and need for home health care or rehabilitation facility on discharge were predictors of 6-month unplanned readmissions. Readmission was least likely for patients covered by private insurance versus Medicaid/no insurance and Medicare populations. Length of stay during index hospitalizations was significantly associated with the likelihood of 6-month unplanned readmission (odds ratio [OR], 2.39).

“Several demographic, clinical, and socioeconomic factors play important roles in predicting readmissions,” the authors write.

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Agarwal S, Pitcavage JM, Sud K, Thakkar B. Burden of readmissions among patients with critical limb ischemia [published online March 6, 2017]. J Am Coll Cardiol. doi: 10.1016/j.jacc.2017.02.040

Shishehbot MH, Aronow HD. Readmissions for critical limb ischemia: hear no evil? [published online March 6, 2017]. J Am Coll Cardiol. doi: 10.1016/j.jacc.2017.02.036