Incidence and causes of early unplanned readmission after hospitalisation with peripheral arterial disease in Australia and New Zealand

Vanessa Woelk, Peter Speck, Billingsley Kaambwa, Robert A. Fitridge, Isuru Ranasinghe

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the characteristics and predictors of unplanned readmission within 30 days of hospitalisation for the treatment of peripheral arterial disease (PAD) in Australia and New Zealand. Design: Analysis of hospitalisations data in the Admitted Patient Collection for each Australian state and territory and the New Zealand National Minimum Dataset (Hospital Events). Setting: All public and 80% of private hospitals in Australia and New Zealand. Participants: Adults (18 years or older) hospitalised with a primary or conditional secondary diagnosis of PAD during 1 January 2010 ‒ 31 December 2015. Main outcome measure: Rate of unplanned readmission (any cause) within 30 days of hospitalisation with PAD. Results: Of 104 979 admissions included in our analysis (mean patient age, 73.7 years; SD, 12.4 years), 9765 were followed by at least one unplanned readmission within 30 days of discharge (9.3%): 3395 within one week (34.8%) and 7828 within three weeks (80.2%). The most frequent readmission primary diagnoses were atherosclerosis (1477, 15.3%), type 2 diabetes (1057, 10.8%), and “complications of procedures not elsewhere classified” (963, 9.9%). Readmission was more frequent after acute (4830 of 26 304, 18.4%) than elective PAD hospitalisations (4935 of 78 675, 6.3%), but the readmission characteristics were similar. Factors associated with greater likelihood of readmission included acute PAD hospitalisations (odds ratio [OR], 2.04; 95% CI, 1.96‒2.17), surgical intervention during the PAD hospitalisation (OR, 1.74; 95% CI, 1.64–1.84), and chronic limb-threatening ischaemia (OR, 1.55; 95% CI, 1.47–1.63). Conclusion: Unplanned readmissions within 30 days of hospitalisation for PAD are often for potentially preventable reasons. Their number should be reduced to improve clinical outcomes for people with PAD.

Original languageEnglish
Number of pages7
JournalMedical Journal of Australia
Early online date2 Nov 2021
DOIs
Publication statusE-pub ahead of print - 2 Nov 2021

Keywords

  • Cardiovascular surgical procedures
  • Health policy
  • Hospital medicine
  • Peripheral vascular diseases
  • Risk management
  • Vascular diseases

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