Critical Limb Ischemia Results in High Readmission

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 the Journal of the American College of Cardiology.

Shikhar Agarwal, MD, MPH, 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 6 months, all-cause readmission rates were 27.1% and 56.6%, respectively; most readmissions were unplanned. The rates of unplanned readmissions were 23.6% and 47.7%, respectively, at 30 days and 6 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 6 months was high in CLI patients, the majority representing unplanned readmissions,” the authors write.

Reference

1. Agarwal S, Pitcavage JM, Sud J, Thakkar B. Burden of readmissions among patients with critical limb ischemia [published online April 2017]. J Am Coll Cardiol. doi: 10.1016/j.jacc.2017.02.040
2. Shishehbor MH, Aronow HD. Readmissions for critical limb ischemia [published online April 2017]. J Am Coll Cardiol. doi: 10.1016/j.jacc.2017.02.036