Risk Factors for 30-Day Hospital Readmission in Patients Undergoing Treatment for Peripheral Artery Disease

Vasc Endovascular Surg. 2015 Apr-May;49(3-4):69-74. doi: 10.1177/1538574415593498. Epub 2015 Jul 5.

Abstract

Early hospital readmission among vascular surgery patients is a focus of Medicare's new reimbursement structure. We aim to identify factors associated with 30-day readmission after lower extremity interventions to treat peripheral artery disease (PAD). Retrospective analysis of 174 consecutive patients discharged from the vascular surgery service between January 1, 2011, and July 31, 2012, after procedures for lower extremity PAD was performed. Of 174 patients, 37 were readmitted within 30 days of discharge. There were no significant differences in baseline characteristics between the readmitted and the nonreadmitted groups. In a multivariate logistic regression model, urgent operation and advanced chronic kidney disease (CKD) were associated with increased risk of 30-day readmission. The most common reasons for readmission were infection of the surgical site or index limb (18 of 37), followed by unresolved limb symptoms (13 of 37). The 30-day readmission is frequent after lower extremity interventions to treat PAD. Urgent operative intervention and advanced CKD appear to be risk factors for early hospital readmission.

Keywords: critical limb ischemia; peripheral vascular disease; readmission.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amputation, Surgical / adverse effects*
  • Endovascular Procedures / adverse effects*
  • Endovascular Procedures / instrumentation
  • Female
  • Humans
  • Ischemia / complications
  • Ischemia / diagnosis
  • Ischemia / therapy*
  • Logistic Models
  • Lower Extremity / blood supply*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Patient Readmission*
  • Peripheral Arterial Disease / complications
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / therapy*
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / diagnosis
  • Retrospective Studies
  • Risk Factors
  • Stents
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / etiology*
  • Time Factors
  • Treatment Outcome