Nonspecific Chest Pain and 30-Day Unplanned Readmissions in the United States (From the Nationwide Readmission Database)
| Autor: | Evangelos Kontopantelis, Jassim Al Suwaidi, Mohamed O. Mohamed, David L. Fischman, Yoon K. Loke, Purvi Parwani, Ritu Thamman, Mamas A. Mamas, Chun Shing Kwok, Josip Anđelo Borovac, David L. Brown |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Chest Pain Cardiovascular investigation chest pain Time Factors Databases Factual Magnetic Resonance Imaging Cine 030204 cardiovascular system & hematology Coronary Angiography computer.software_genre Chest pain Patient Readmission Coronary artery disease Angina 03 medical and health sciences 0302 clinical medicine Risk Factors Humans Medicine Registries 030212 general & internal medicine Retrospective Studies Database business.industry Retrospective cohort study Odds ratio Middle Aged RC666 Prognosis medicine.disease R1 United States Confidence interval Heart failure non-cardiac chest pain Female myocardial infarction readmissions united states emergency medicine cardiology medicine.symptom Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business computer |
| Zdroj: | Kwok, C S, Parwani, P J, Fischman, D L, Thamman, R, al Suwaidi, J, Mohamed, M, Borovac, J A, Loke, Y K, Kontopantelis, E, Brown, D & Mamas, M 2019, ' Non-specific Chest Pain and 30-day Unplanned Readmissions in the United States: (From the Nationwide Readmission Database) ', American Journal of Cardiology . https://doi.org/10.1016/j.amjcard.2019.01.012 |
| ISSN: | 0002-9149 1879-1913 |
| DOI: | 10.1016/j.amjcard.2019.01.012 |
| Popis: | Chest pain is a common reason for admission to hospital and little is known regarding 30-day unplanned readmissions after an admission with a primary discharge diagnosis of nonspecific chest pain. We analyzed patients with a primary diagnosis of nonspecific chest pain in the Nationwide Readmission Database who were admitted in 2010 to 2014. Rates, causes, and predictors of 30-day unplanned readmissions were determined. A total of 1, 842, 270 patients had a diagnosis of nonspecific chest pain. The 30-day unplanned readmission rate was 8.6%. From 2010 to 2014, there was an increase in 30- day unplanned readmissions from 8.1% to 9.5%. The majority of 30-day unplanned readmissions were for noncardiac reasons (73.4%). The 3 most prevalent noncardiac causes for readmissions were neuropsychiatric (10.9%), gastrointestinal (10.5%), and infections (9.9%), while the 3 most prevalent cardiac causes were coronary artery disease including angina (8.4%), arrhythmias (6.6%), and heart failure 5.5%. The strongest predictors of readmission were alcohol misuse ([OR] odds ratio 1.74 95% [CI] confidence interval 1.66– 1.81), renal failure (OR 1.82 95%CI 1.76–1.87), cancer (OR 2.40 95%CI 2.27–2.53), discharge to a nursing home (OR 2.26 95%CI 2.18–2.34), and discharge against medical advice (OR 1.94 95%CI 1.86– 2.02). The rate of 30-day unplanned readmission was 6.1% among those who received any test compared to 9.3% in those who did not receive any test. Rates of early unplanned readmissions occur following 1 in 12 admissions for nonspecific chest pain with noncardiac causes being the most common reason. Patients who receive a cardiovascular investigation appear to have fewer unplanned readmissions. |
| Databáze: | OpenAIRE |
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