Clinical Research StudyRate, Causes, and Predictors of 30-Day Readmission Following Hospitalization for Acute Pericarditis
Introduction
Acute pericarditis accounts for 5% of emergency department visits for chest pain in North America.1 Although mortality associated with acute pericarditis is low, patients are often hospitalized for initial management.2,3 Incessant and recurrent pericarditis are the most common complications of acute pericarditis.1,4 Although the pathophysiology of these conditions is not completely understood,1 prospective studies have reported recurrence in up to 30% of patients over 18 months after an episode of acute pericarditis.5 Despite this, studies examining rehospitalizations after acute pericarditis are very limited.1,3 Accordingly, we examined the readmissions within 30 days after an episode of acute pericarditis in the United States to determine the rate, predictors, and outcomes of this untoward complication.
Section snippets
Methods
We analyzed the National Readmission Database (NRD) maintained by the Healthcare Cost and Utilization Project (HCUP) for the years 2016 and 2017. The NRD contains stratified weighted data from 20% of all non-federal acute care hospitals in the United States, allowing for the creation of national estimates of inpatient hospitalizations and subsequent readmissions. NRD tracks each admission for subsequent readmissions during the calendar year by using a unique patient linkage number specific to
Study Population and Initial Hospitalization
We identified a total of 21,335 patients who were discharged following a hospitalization for acute pericarditis in the United States in the years 2016-2017 (Figure 1). Baseline characteristics are presented according to readmission status in Table 1. The mean age of the study cohort was 52.5 ± 0.2 years, and 38.3% of the patients were women. Women had a significantly higher prevalence of autoimmune diseases compared with men (7.6% vs 1.4, P < 0.001) among our study population. The etiology of
Discussion
In this study, we report certain key findings about readmission following hospitalization for acute pericarditis: 1) the rate of readmission at 30 days was substantial at 12.9%; 2) the single most common cause for readmission was pericardial disease; 3) older age, female sex, dialysis dependence, COPD, and the presence of a pericardial effusion during the index hospitalization identified patients at higher risk of readmission within 30 days; 4) 30-day readmission mortality was more than
Conclusion
Readmission within 30 days of hospitalization for acute pericarditis is common, and is associated with significant morbidity, mortality, and health care costs. Older age, female sex, dialysis dependence, COPD, and the presence of pericardial effusion during the index hospitalization are independently predictive of a higher risk of readmission. Once readmitted, patients with renal or pulmonary comorbidities are at a higher risk for mortality. Further research aimed at improving outcomes in
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Cited by (4)
A Brief Overview of Recurrent Pericarditis Management and the Potential of Rilonacept as a New Therapeutic Option
2022, American Journal of Cardiovascular DrugsRecurrent pericarditis: an update on diagnosis and management
2021, Internal and Emergency MedicineInfection: Pericarditis
2021, Imaging of Inflammation and Infection in Cardiovascular Diseases
Funding: None.
Conflict of Interest: None.
Authorship: JS: Conceptualization, validation, formal analysis, data curation, writing—original draft, writing—review and editing; MSK: Conceptualization, writing—original draft, resources; UH: Validation, formal analysis, data curation, visualization; SUK: Writing—review and editing, resources, formal analysis; WSA: Validation, writing—review and editing; FM: Writing—review and editing; RAK: Conceptualization, writing—review and editing; HAC: Conceptualization, writing—review and editing; EDM: Writing—review and editing, supervision; JAP: Conceptualization, writing—review and editing, supervision.