Table 2:
Predictors of 30-day unplanned readmissions after LVAD implantation in 2013.
| VARIABLE | Adjusted OR (95% CI) | P-value |
|---|---|---|
| Age (years) | ||
| 18–34 | 1.46 (057 – 3.71) | 0.41 |
| 35–49 | 1.41 (0.73 – 2.73) | 0.30 |
| 50–64 | 1.69 (1.06– 2.68) | 0.02 |
| ≥65 | Referent | |
| Men | Referent | |
| Women | 1.10 (0.71 – 1.74) | 0.65 |
| Stroke | 0.36 (0.18 – 0.71) | 0.0030 |
| Pneumonia | 0.50 (0.26 – 0.93) | 0.03 |
| Diabetes Mellitus | 0.69 (0.46 – 1.04) | 0.07 |
| Perivascular diseases | 2.15 (0.93 – 4.980 | 0.07 |
| Coagulation disorder | 1.42 (0.90 – 2.330 | 0.13 |
| Old Myocardial Infarction | 1.18 (0.68 – 2.06) | 0.54 |
| Hypertension with Complications | 1.1 (0.67 – 1.77) | 0.71 |
| Electrolytes | 0.96 (0.65 – 1.43) | 0.85 |
| Obesity* | 1.09 (0.72 – 1.65) | 0.68 |
| COPD | 1.006 (0.64 – 1.74) | 0.81 |
| Median household income category for patient’s zip code† (percentile) | ||
| 0–25th | Referent | |
| 26–50th | 1.25 (0.72 – 2.16) | 0.42 |
| 51–75th | 1.29 (0.69–2.40) | 0.42 |
| 76–100th | 1.38 (0.72–2.64) | 0.33 |
| INDEX ADMISSION CHARACTERISTICS | ||
| Admission Source‡ | ||
| Non-Emergency Department | 1.04 (0.62–1.75) | 0.89 |
| Emergency Department | Referent | |
| Admission Type | ||
| Non-Elective | 1.16 (0.70–1.92) | 0.55 |
| Elective | Referent | |
| APRDRG Severity Scale§ | ||
| Moderate or Major loss of function | Referent | |
| Extreme loss of function | 0.60 (0.32 – 1.10 | 0.09 |
| Length of Stay (Days) | ||
| <20 | Referent | |
| 21–30 | 1.17 (0.71–1.94) | 0.53 |
| 31–40 | 1.80 (0.94–3.44) | 0.07 |
| >=41 | 2.78 (1.54–5.02) | 0.001 |
| Primary Payer type | ||
| Medicare | 2.36 (1.21 – 4.63) | 0.01 |
| Medicaid | Referent | |
| Private | 1.08 (0.57 – 2.02) | 0.81 |
| Self pay or No Charge or Others | 0.81 (0.27 – 2.42) | 0.68 |
| Discharge Disposition | ||
| Routine | Referent | |
| Short term Hospital | 0.19 (0.02 – 0.61) | 0.01 |
| Nursing Facility | 1.37 (0.86 – 2.20) | 0.18 |
| Home Health Care | 1.02 (0.72 – 1.43) | 0.91 |
| HOSPITAL CHARACTERISTICS | ||
| Hospital bed size∥ | ||
| Small | Referent | |
| Medium | 5.24 (1.55 – 17.70) | 0.008 |
| Large | 5.48 (2.37 – 13.07) | 0.003 |
| Hospital Type# | ||
| Metropolitan non-teaching | 0.70 (0.41 – 1.18) | 0.18 |
| Metropolitan teaching | Referent | |
| Hospital Control¶ | ||
| Government, Nonfederal | Referent | |
| Private | 1.01 (0.48 – 2.15) | 0.97 |
| Hospital urban-rural designation | ||
| Large metropolitan (serving at least 1 million residents) | Referent | |
| Small metropolitan (<1 million residents) | 0.79 (0.42 – 1.50) | 0.46 |
Obesity was defined using ICD-9-CM diagnoses and the Diagnosis Related Group (DRG) in effect on the discharge date.
This represents a quartile classification of the estimated median household income of residents in the patient’s ZIP Code. These values are derived from ZIP Code-demographic data obtained from Claritas. The quartiles are identified by values of 1 to 4, indicating the poorest to wealthiest populations.
HCUP criteria for evidence of ED services includes: 1)Emergency department revenue code of 450–459 on record; 2) Positive emergency department charge, when revenue center codes are not available; 3) Emergency department CPT code of 99281–99285 reported on record; 4) Condition Code of P7 (NUBC preferred coding for public reporting as of July 1, 2010); 5) Point of origin of ED (NUBC preferred coding from October 1, 2007 to June 30, 2010); 6) Admission source of ED (NUBC preferred coding prior to October 1, 2007).
The All Patient Refined Diagnosis Related Groups (APR-DRGs) are assigned using software developed by 3M Health Information Systems.
Bed size categories are based on hospital beds, and are specific to the hospital’s location and teaching status. Bed size assesses the number of short-term acute beds in a hospital. Hospital information was obtained from the AHA Annual Survey of Hospitals.
The hospital’s teaching status was obtained from the AHA Annual Survey of Hospitals. A hospital is considered to be a teaching hospital if it has an AMA-approved residency program, is a member of the Council of Teaching Hospitals (COTH) or has a ratio of full-time equivalent interns and residents to beds of .25 or higher. The metropolitan categorization is a simplified adaptation of the 2003 version of the Urban Influence Codes (UIC) and includes both large and small metropolitan areas.
The hospital’s ownership/control category was obtained from the AHA Annual Survey of Hospitals and includes categories for government nonfederal (public), private {not-for-profit (voluntary and private investor-owned (proprietary)}. Hospitals in different ownership/control categories tend to have different missions and different responses to government regulations and policies.
Frequencies (%) in the columns may not sum to 100% since there might be missing data