Risk factors for 30‐day readmission in adults hospitalized for pulmonary hypertension

Abstract

Readmissions for pulmonary hypertension are poorly understood and understudied. We sought to determine national estimates and risk factors for 30-day readmission after pulmonary hypertension-related hospitalizations. We utilized the Healthcare Cost and Utilization Project Nationwide Readmission Database, which has weighted estimates of roughly 35 million discharges in the US. Adult patients with primary International Classification of Disease, Ninth Revision, Clinical Modification diagnosis codes of 416.0 and 416.8 for primary and secondary pulmonary hypertension with an index admission between 2012 and 2014 and any readmission within 30 days of the index event were identified. Predictors of 30-day readmission were identified using multivariable logistic regression with adjustment for covariates. Results showed that the national estimate for Primary Pulmonary Hypertension vs Secondary Pulmonary Hypertension-related index events between 2012 and 2014 with 30-day readmission was 247 vs 2550 corresponding to a national readmission risk estimate of 17% vs 18.3%, respectively. The presence of fluid and electrolyte disorders, renal failure, and alcohol abuse were associated with increased risk of readmission in Primary Pulmonary Hypertension, while factors associated with Secondary Pulmonary Hypertension readmissions included anemia, congestive heart failure, lung disease, fluid and electrolyte disorders, renal failure, diabetes, and liver disease. The median cost of Primary Pulmonary Hypertension admissions and readmissions were $46,132 (IQR: $25,384–$85,647) and $41,604.50 (IQR: $22,481.50–$84,420.50), respectively. The median costs of Secondary Pulmonary Hypertension admissions and readmissions were $34,893 (IQR: $19,670–$66,143) and $36,279 (IQR: $19,059–$74,679), respectively. In conclusion, approximately 19% of Primary Pulmonary Hypertension and Secondary Pulmonary Hypertension hospitalizations result in 30-day readmission, with significant costs accrued during the index hospitalization and readmission. With evolving clinical terminology and diagnostic codes, future study will need to better clarify underlying factors associated with readmissions amongst pulmonary hypertension sub-types, and identify methods and procedures to minimize readmission risk.

Real-world assessment of “OFF” episode–related healthcare resource utilization among patients with Parkinson’s disease in the United States

“…Costs data for this study were obtained from HCUPnet, which is sponsored by AHRQ 20 . While costs may not be exact for patients with PD, there are studies that have utilized AHRQ as a source to derive costs data in other disease states [29][30][31] . In our study, the higher level of HCRU reported for patients experiencing "OFF" episodes was reflected in higher healthcare costs than those in patients not experiencing "OFF" episodes.…”

Explainable machine learning models for predicting 30-day readmission in pediatric pulmonary hypertension: A multicenter, retrospective study

“…A total of 32 variables associated with readmission were collected according to relevant studies and clinical availability ( 7 , 15 ), including patient demographics (gender and age), length of stay (LOS), etiology of PH, comorbidities, targeted pharmacotherapy for PH during hospitalization, use of mechanical ventilation, and nonmedical order discharge. All data for included variables were extracted from inpatient electronic medical records.…”