Table 1.
Baseline characteristics and procedure-related factors during index admission for CAS
| No early readmissions (n = 15,512; 92.6%) | 30-day readmission (n = 1233; 7.4%) | Overall (n = 16,745) | p value | Odds ratio (95% CI) | |
|---|---|---|---|---|---|
| Age (years) (median [IQR]) | 70 [62–77] | 73 [65–79] | 70 [62–77] | < 0.001 | |
| Female | 37.7% | 40.9% | 38.0% | 0.028 | 1.141 (1.014–1.284) |
| Elective | 59.8% | 48.2% | 59.0% | < 0.001 | 0.623 (0.555–0.701) |
| Weekend admission | 10.1% | 13.6% | 10.4% | < 0.001 | 1.402 (1.182–1.663) |
| Primary expected payer | < 0.001 | ||||
| Medicare | 70.2% | 77.9% | 70.8% | ||
| Medicaid | 6.5% | 6.0% | 6.4% | ||
| Private | 18.8% | 13.5% | 18.4% | ||
| Self-pay | 1.4% | 0.7% | 1.4% | ||
| No charge | 0.1% | 0.0% | 0.1% | ||
| Other | 2.9% | 1.9% | 2.9% | ||
| Quartile of median household income | 0.009 | ||||
| 0–25th | 30.1% | 28.1% | 29.9% | ||
| 26th–50th | 29.7% | 29.1% | 29.7% | ||
| 51st–75th | 25.6% | 24.7% | 25.5% | ||
| 76th–100th | 14.6% | 18.1% | 14.8% | ||
| Comorbidities | |||||
| Tobacco use disorders/smoker | 23.1% | 22.3% | 23.0% | 0.523 | 0.956 (0.831–1.098) |
| Alcohol use disorders | 3.1% | 3.2% | 3.1% | 0.833 | 1.036 (0.744–1.444) |
| Lipid disorders | 66.0% | 65.9% | 66.0% | 0.943 | 0.996 (0.881–1.125) |
| Hypertension | 59.4% | 50.4% | 58.7% | < 0.001 | 0.695 (0.619–0.781) |
| Diabetes | 34.8% | 42.0% | 35.3% | < 0.001 | 1.359 (1.208–1.528) |
| Obesity | 13.2% | 15.2% | 13.3% | 0.046 | 1.179 (1.002–1.387) |
| Heart failure | 12.8% | 25.1% | 13.7% | < 0.001 | 2.270 (1.979–2.603) |
| Coronary artery disease | 45.3% | 52.0% | 45.8% | < 0.001 | 1.307 (1.164–1.468) |
| Previous PCI | 13.7% | 16.2% | 13.9% | 0.014 | 1.219 (1.041–1.428) |
| Previous CABG | 0.6% | 0.9% | 0.6% | 0.221 | 1.476 (0.788–2.765) |
| Valvular heart disease | 6.8% | 9.1% | 7.0% | 0.003 | 1.365 (1.113–1.674) |
| Dysrhythmias | 16.7% | 25.6% | 17.3% | < 0.001 | 1.721 (1.504–1.969) |
| Atrial fibrillation/flutter | 14.4% | 22.5% | 15.0% | < 0.001 | 1.733 (1.505–1.995) |
| Symptomatic carotid stenosis | 92.0% | 91.7% | 92.0% | 0.716 | 0.962 (0.779–1.187) |
| Periprocedural cerebral infarction | 29.0% | 36.3% | 29.5% | < 0.001 | 1.397 (1.238–1.577) |
| Prior transient ischemic attack or stroke without residual deficit | 23.8% | 23.3% | 23.7% | 0.703 | 0.974 (0.849–1.117) |
| Depression | 9.9% | 15.0% | 10.3% | < 0.001 | 1.610 (1.365–1.898) |
| Dementia/neurocognitive disorders | 4.3% | 7.1% | 4.5% | < 0.001 | 1.716 (1.363–2.160) |
| Peripheral vascular disease | 21.4% | 25.2% | 21.7% | 0.002 | 1.241 (1.085–1.419) |
| Pulmonary circulatory disorders | 2.4% | 5.1% | 2.6% | < 0.001 | 2.191 (1.667–2.881) |
| GI bleed | 1.0% | 2.5% | 1.1% | < 0.001 | 2.459 (1.667–3.628) |
| COPD | 20.8% | 27.0% | 21.3% | < 0.001 | 1.407 (1.234–1.605) |
| Hepatic failure | 0.1% | 0.2% | 0.1% | 0.321 | 2.098 (0.469–9.386) |
| Thyroid disorders | 14.1% | 14.5% | 14.1% | 0.694 | 1.034 (0.877–1.219) |
| CKD | 15.3% | 25.0% | 16.0% | < 0.001 | 1.845 (1.610–2.114) |
| AKI | 6.4% | 14.2% | 7.0% | < 0.001 | 2.429 (2.044–2.886) |
| Fluid and electrolyte disorder | 12.8% | 21.7% | 13.5% | < 0.001 | 1.886 (1.634–2.176) |
| Acute hemorrhagic anemia | 4.8% | 7.2% | 5.0% | < 0.001 | 1.532 (1.220–1.925) |
| Coagulation disorders | 3.6% | 6.9% | 3.8% | < 0.001 | 1.999 (1.579–2.531) |
| Cancer | 4.1% | 7.4% | 4.3% | < 0.001 | 1.870 (1.489–2.348) |
| APR DRG mortality risk | < 0.001 | ||||
| Minor likelihood of dying | 38.7% | 24.3% | 37.6% | ||
| Moderate likelihood of dying | 39.7% | 38.7% | 39.6% | ||
| Major likelihood of dying | 14.4% | 23.9% | 15.1% | ||
| Extreme likelihood of dying | 7.2% | 13.1% | 7.6% | ||
| APR DRG severity of illness | < 0.001 | ||||
| Minor loss of function (includes cases with no comorbidity or complications) | 27.6% | 18.5% | 27.0% | ||
| Moderate loss of function | 39.1% | 33.3% | 38.7% | ||
| Major loss of function | 26.2% | 35.5% | 26.9% | ||
| Extreme loss of function | 7.0% | 12.7% | 7.4% | ||
| Hospital bed size | 0.284 | ||||
| Small | 5.5% | 4.5% | 5.4% | ||
| Medium | 23.3% | 24.2% | 23.3% | ||
| Large | 71.3% | 71.4% | 71.3% | ||
| Control/ownership of hospital | 0.010 | ||||
| Government, nonfederal | 11.9% | 10.2% | 11.8% | ||
| Private, not-profit | 76.9% | 76.1% | 76.8% | ||
| Private, invest-own | 11.2% | 13.7% | 11.4% | ||
| Hospital urban rural designation | < 0.001 | ||||
| Large metropolitan areas with at least 1 million residents | 47.6% | 55.2% | 48.2% | ||
| Small metropolitan areas with fewer than 1 million residents | 49.4% | 42.9% | 48.9% | ||
| Micropolitan areas | 3.0% | 1.9% | 2.9% | ||
| Not metropolitan or micropolitan (non-urban residual) | 0.0% | 0.0% | 0.0% | ||
| Hospital teaching status | 0.010 | ||||
| Metropolitan non-teaching hospital | 14.4% | 16.6% | 14.6% | ||
| Metropolitan teaching hospital | 82.6% | 81.5% | 82.5% | ||
| Non-metropolitan hospital | 3.0% | 1.9% | 2.9% | ||
| Procedural characteristics | |||||
| Vasopressor use | 1.5% | 2.8% | 1.6% | 0.001 | 1.828 (1.270–2.630) |
| Cardiac arrest | 0.3% | 0.9% | 0.4% | 0.003 | 2.625 (1.368–5.039) |
| In-hospital bleeding | 1.0% | 1.9% | 1.0% | 0.002 | 1.973 (1.267–3.074) |
| In-hospital vascular complications | 0.1% | 0.1% | 0.1% | 0.726 | 0.699 (0.093–5.238) |
| Discharge destination | < 0.001 | ||||
| Home/self-care | 75.5% | 61.1% | 74.4% | ||
| Home healthcare | 0.4% | 1.0% | 0.5% | ||
| Discharge against medical advice | 0.3% | 0.5% | 0.3% | ||
| Length of stay and cost analysis | |||||
| Index admission length of stay (days) (median [IQR]) | 2 [1–6] | 3 [1–10] | 2 [1–6] | < 0.001 | |
| Index admission cost (US $) (median [IQR]) | 16,523 [11095–28771] | 21,274 [12684–37720] | 16,788 [11188–29586] | < 0.001 | |
| Readmission length of stay (days) (median [IQR]) | 2 [3–6] | ||||
| Readmission cost (US $) (median [IQR]) | 9768 [5009–14242] | ||||
IQR interquartile range, PCI percutaneous coronary intervention, CABG coronary artery bypass grafting, GI gastrointestinal, AKI acute kidney injury, CKD chronic kidney disease, COPD chronic obstructive pulmonary disease, APRDRG All Patient Refined Diagnosis Related Group