Gender disparities, causes and predictors of immediate and short-term cardiovascular readmissions following COVID-19-related hospitalisations in the USA.

Autor:	Vardar U; Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA ufukvardar96@gmail.com., Shaka H; Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA., Kumi D; Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA., Gajjar R; Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA., Bess O; Department of Medicine, Woodhull Hospital, Brooklyn, New York, USA., Kanemo P; Department of Medicine, Rapides Regional Medical Center, Alexandria, Louisiana, USA., Shaka A; Department of Medicine, Windsor University School of Medicine, Cayon, Saint Kitts and Nevis., Baskaran N; Department of Medicine, University of Florida, Gainesville, Florida, USA.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Nov 10; Vol. 13 (11), pp. e073959. Date of Electronic Publication: 2023 Nov 10.
DOI:	10.1136/bmjopen-2023-073959
Abstrakt:	Objectives: In this study, we aimed to identify the causes, predictors and gender disparities of 30-day and 90-day cardiovascular readmissions after COVID-19-related hospitalisations using National Readmission Database (NRD) 2020. Setting: We used the NRD from 2020 to identify hospitalised adults with a principal diagnosis of COVID-19 infection. Participants: We included subjects who were readmitted within 30 days and 90 days after index admission. We excluded subjects with elective and traumatic admissions. We used a multivariate Cox regression model to identify independent predictors of readmission. Primary and Secondary Outcomes Measures: Our outcomes were inpatient mortality, 30-day and 90-day cardiovascular readmission rates following COVID-19 infection. Results: During the study period, there were 1 024 492 index hospitalisations with a primary diagnosis of COVID-19 infection in the 2020 NRD database, 644 903 (62.9%) were included for 30-day readmission analysis, and 418 122 (40.8%) were included for 90-day readmission analysis. Of patients involved in the 30-day analysis, 7140 (1.1%) patients had a readmission within 30 days; of patients involved in the 90-day analysis, 8379 (2.0%) had a readmission within 90 days due to primarily cardiovascular causes. Cox regression analysis revealed that the female sex (aHR 0.89; 95% CI 0.82 to 0.95; p=0.001) was associated with a lower hazard of 30-day cardiovascular readmissions; however, congestive heart failure (aHR 2.45; 95% CI 2.2 to 2.72; p<0.001), arrhythmias (aHR 2.45; 95% CI 2.2 to 2.72; p<0.001) and valvular disease (aHR 2.45; 95% CI 2.2 to 2.72; p<0.001) had a higher hazard. The most common causes of cardiovascular readmissions were heart failure (34.3%), deep vein thrombosis/pulmonary embolism (22.5%) and atrial fibrillation (9.5%). Conclusion: Our study demonstrates that male gender, heart failure, arrhythmias and valvular disease carry higher hazards of 30-day and 90-day cardiovascular readmissions. Identifying risk factors and common causes of readmission may assist with lowering the burden of cardiovascular disease in patients with COVID-19 infection. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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