Causes and Predictors of 30‐Day Readmission in Patients With Syncope/Collapse: A Nationwide Cohort Study
Background Syncope accounts for 0.6% to 1.5% of hospitalizations in the United States. We sought to determine the causes and predictors of 30‐day readmission in patients with syncope. Methods and Results We identified 323 250 encounters with a primary diagnosis of syncope/collapse in the 2013–2014 N...
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Wiley
2018-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.009746 |
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| author | Amer N. Kadri Hasan Abuamsha Leen Nusairat Nazih Kadri Hussam Abuissa Ahmad Masri Adrian V. Hernandez |
| author_facet | Amer N. Kadri Hasan Abuamsha Leen Nusairat Nazih Kadri Hussam Abuissa Ahmad Masri Adrian V. Hernandez |
| author_sort | Amer N. Kadri |
| collection | DOAJ |
| description | Background Syncope accounts for 0.6% to 1.5% of hospitalizations in the United States. We sought to determine the causes and predictors of 30‐day readmission in patients with syncope. Methods and Results We identified 323 250 encounters with a primary diagnosis of syncope/collapse in the 2013–2014 Nationwide Readmissions Database. We excluded patients younger than 18 years, those discharged in December, those who died during hospitalization, hospital transfers, and those whose length of stay was missing. We used multivariable logistic regression analysis to evaluate the association between baseline characteristics and 30‐day readmission. A total of 282 311 syncope admissions were included. The median age was 72 years (interquartile range, 58–83), 53.9% were women, and 9.3% had 30‐day readmission. The most common cause of 30‐day readmissions was syncope/collapse, followed by cardiac, neurological, and infectious causes. Characteristics associated with 30‐day readmissions were age 65 years and older (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6–0.7), female sex (OR, 0.9; 95% CI, 0.8–0.9), congestive heart failure (OR, 1.5; 95% CI, 1.2–1.9), atrial fibrillation/flutter (OR, 1.3; 95% CI, 1.3–1.4), diabetes mellitus (OR, 1.2; 95% CI, 1.2–1.3), coronary artery disease (OR, 1.2; 95% CI, 1.2–1.3), anemia (OR, 1.4; 95% CI, 1.4–1.5), chronic obstructive pulmonary disease (OR, 1.4; 95% CI, 1.3–1.4), home with home healthcare disposition (OR, 1.5; 95% CI, 1.5–1.6), leaving against medical advice (OR, 1.7; 95% CI, 1.6–1.9), length of stay of 3 to 5 days (OR, 1.5; 95% CI, 1.4–1.6) or >5 days (OR, 2; 95% CI, 1.8–2), and having private insurance (OR, 0.6; 95% CI, 0.6–0.7). Conclusions The 30‐day readmission rate after syncope/collapse was 9.3%. We identified causes and risk factors associated with readmission. Future prospective studies are needed to derive risk‐stratification models to reduce the high burden of readmissions. |
| format | Article |
| id | doaj-art-d43f8ef1ddfe4b2993e6bd06e042bf39 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2018-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-d43f8ef1ddfe4b2993e6bd06e042bf392025-08-20T02:34:38ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-09-0171810.1161/JAHA.118.009746Causes and Predictors of 30‐Day Readmission in Patients With Syncope/Collapse: A Nationwide Cohort StudyAmer N. Kadri0Hasan Abuamsha1Leen Nusairat2Nazih Kadri3Hussam Abuissa4Ahmad Masri5Adrian V. Hernandez6Cleveland Clinic Foundation Cleveland OHSt. Vincent Charity Medical Center—Case Western Reserve University Cleveland OHCleveland Clinic Foundation Cleveland OHICCE/Jordan Hospital Amman JordanCreighton University Omaha NEUniversity of Pittsburgh PAUniversity of Connecticut/Hartford Hospital Evidence‐Based Practice Center Hartford CTBackground Syncope accounts for 0.6% to 1.5% of hospitalizations in the United States. We sought to determine the causes and predictors of 30‐day readmission in patients with syncope. Methods and Results We identified 323 250 encounters with a primary diagnosis of syncope/collapse in the 2013–2014 Nationwide Readmissions Database. We excluded patients younger than 18 years, those discharged in December, those who died during hospitalization, hospital transfers, and those whose length of stay was missing. We used multivariable logistic regression analysis to evaluate the association between baseline characteristics and 30‐day readmission. A total of 282 311 syncope admissions were included. The median age was 72 years (interquartile range, 58–83), 53.9% were women, and 9.3% had 30‐day readmission. The most common cause of 30‐day readmissions was syncope/collapse, followed by cardiac, neurological, and infectious causes. Characteristics associated with 30‐day readmissions were age 65 years and older (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6–0.7), female sex (OR, 0.9; 95% CI, 0.8–0.9), congestive heart failure (OR, 1.5; 95% CI, 1.2–1.9), atrial fibrillation/flutter (OR, 1.3; 95% CI, 1.3–1.4), diabetes mellitus (OR, 1.2; 95% CI, 1.2–1.3), coronary artery disease (OR, 1.2; 95% CI, 1.2–1.3), anemia (OR, 1.4; 95% CI, 1.4–1.5), chronic obstructive pulmonary disease (OR, 1.4; 95% CI, 1.3–1.4), home with home healthcare disposition (OR, 1.5; 95% CI, 1.5–1.6), leaving against medical advice (OR, 1.7; 95% CI, 1.6–1.9), length of stay of 3 to 5 days (OR, 1.5; 95% CI, 1.4–1.6) or >5 days (OR, 2; 95% CI, 1.8–2), and having private insurance (OR, 0.6; 95% CI, 0.6–0.7). Conclusions The 30‐day readmission rate after syncope/collapse was 9.3%. We identified causes and risk factors associated with readmission. Future prospective studies are needed to derive risk‐stratification models to reduce the high burden of readmissions.https://www.ahajournals.org/doi/10.1161/JAHA.118.00974630‐day readmissionhospitalizationquality improvementsyncope |
| spellingShingle | Amer N. Kadri Hasan Abuamsha Leen Nusairat Nazih Kadri Hussam Abuissa Ahmad Masri Adrian V. Hernandez Causes and Predictors of 30‐Day Readmission in Patients With Syncope/Collapse: A Nationwide Cohort Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 30‐day readmission hospitalization quality improvement syncope |
| title | Causes and Predictors of 30‐Day Readmission in Patients With Syncope/Collapse: A Nationwide Cohort Study |
| title_full | Causes and Predictors of 30‐Day Readmission in Patients With Syncope/Collapse: A Nationwide Cohort Study |
| title_fullStr | Causes and Predictors of 30‐Day Readmission in Patients With Syncope/Collapse: A Nationwide Cohort Study |
| title_full_unstemmed | Causes and Predictors of 30‐Day Readmission in Patients With Syncope/Collapse: A Nationwide Cohort Study |
| title_short | Causes and Predictors of 30‐Day Readmission in Patients With Syncope/Collapse: A Nationwide Cohort Study |
| title_sort | causes and predictors of 30 day readmission in patients with syncope collapse a nationwide cohort study |
| topic | 30‐day readmission hospitalization quality improvement syncope |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.009746 |
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