30-Day Cardiovascular Readmissions Following Discharge With COVID-19: A US Nationwide Readmission Database Analysis From the Pandemic Year 2020

BACKGROUND: COVID-19 is known to be associated with a myriad of cardiovascular (CV) complications during acute illness, but the rates of readmissions for CV complications after COVID-19 infection are less well established. METHODS: The US Nationwide Readmission Database was utilized to identify COVI...

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Detalles Bibliográficos
Autores principales: Zahid, Salman, Khan, Muhammad Zia, Shatla, Islam, Kaur, Gurleen, Michos, Erin D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158170/
https://www.ncbi.nlm.nih.gov/pubmed/37362314
http://dx.doi.org/10.1016/j.cjco.2023.04.007
Descripción
Sumario:BACKGROUND: COVID-19 is known to be associated with a myriad of cardiovascular (CV) complications during acute illness, but the rates of readmissions for CV complications after COVID-19 infection are less well established. METHODS: The US Nationwide Readmission Database was utilized to identify COVID-19 admissions that occurred in the period from April 1st to November 30th, 2020, using International Classification of Diseases, 10th edition, Clinical Modification administrative claims. RESULTS: A total of 521,351 admissions for COVID-19 were identified. The all-cause 30-day readmission rate was 11.6% (n = 60,262). The incidence of CV-related readmissions was 5.1% (n = 26,725), accounting for 44.3% of all-cause 30-day readmissions. Both CV-related and non-CV-related readmissions occurred at a median of 7 days. Patients readmitted with CV causes had a higher comorbidity burden, with a median Charlson comorbidity score of 6. The most common CV cause of readmission was acute heart failure (8.5%), followed by acute myocardial infarction (5.2%). Venous thromboembolism and stroke during 30-day readmission occurred at rates of 4.6% and 3.6%, respectively. Stress cardiomyopathy and acute myocarditis were less frequent, with incidences of 0.1% and 0.2%, respectively. CV-related readmissions were associated with higher mortality, compared with non-CV-related readmissions (16.5% vs 7.5%, P < 0.01). Each 30-day CV-related readmission was associated with greater cost of care than each non-CV-related readmission ($13,803 vs $10,310, P < 0.01). CONCLUSIONS: Among survivors of index COVID-19 admission, 44.7% of all 30-day readmissions were attributed to CV causes. Acute heart failure remains the most common cause of readmission after COVID-19, followed closely by acute myocardial infarction. CV causes of readmissions remain a significant source of mortality, morbidity, and resource utilization.

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