Development of Risk Model to Predict 30-Day Readmission in PCI Patients
A simple risk score model could help identify the risk of 30-day readmission in patients undergoing PCI, according to a recent study published in Catheterization and Cardiovascular Interventions.
Led by Karl E. Minges, PhD, MPH, et al., the study linked data on 388,078 PCI patients (≥65 years), who were treated at a hospital participating in ACC’s CathPCI Registry, to Medicare fee-for-service claims made between January 2007 and December 2009. The researchers randomly assigned patients to either a development cohort (n = 194,179) or a validation cohort (n = 193,899) and found similar mean 30-day unplanned readmission rates for both cohorts (11.35 percent vs. 11.36 percent respectively). Clinical and demographic characteristics were also similar across both groups.
Of the 19 total variables associated with the risk of 30-day readmission, 14 variables were included to identify high and low risk of 30-day readmission with a point system ranging from one to six. "Due to the challenge of quickly estimating risk […] based on 14 variables," the authors suggest that the "risk score may be a candidate for future calculator app development."
Upon applying the risk model to the study population, the researchers found that 15 percent of PCI patients scored ≥13 and 42 percent scored ≤6. Those who scored higher had a risk of 30-day readmission greater than 18 percent, whereas those with a lower score had a less than 8 percent risk of 30-day readmission.
"The employment of this risk score in the clinical setting may translate to improved patient outcomes, proper quality assessment, and guided resource management, specifically for those patients at highest risk of readmissions," write the authors. "Future research is needed to identify intervention strategies to reduce readmission rates, as well as identify the broader nonclinical factors that may be related to risk of 30-day readmission, such as access to and coordination of care, social support, and hospital culture and organizational behavior."
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