Causes and predictors of 30-day readmission in patients with syncope/collapse: A nationwide cohort study

Amer N. Kadri, Hasan Abuamsha, Leen Nusairat, Nazih Kadri, Hussam Abuissa, Ahmad Masri, Adrian V. Hernandez

Research output: Contribution to journalArticle

Abstract

Background Syncope accounts for 0.6% to 1.5% of hospitalizations in the United States. We sought to determine the causes and predictors of 30‐day readmission in patients with syncope. Methods and Results We identified 323 250 encounters with a primary diagnosis of syncope/collapse in the 2013-2014 Nationwide Readmissions Database. We excluded patients younger than 18 years, those discharged in December, those who died during hospitalization, hospital transfers, and those whose length of stay was missing. We used multivariable logistic regression analysis to evaluate the association between baseline characteristics and 30‐day readmission. A total of 282 311 syncope admissions were included. The median age was 72 years (interquartile range, 58-83), 53.9% were women, and 9.3% had 30‐day readmission. The most common cause of 30‐day readmissions was syncope/collapse, followed by cardiac, neurological, and infectious causes. Characteristics associated with 30‐day readmissions were age 65 years and older (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6-0.7), female sex (OR, 0.9; 95% CI, 0.8-0.9), congestive heart failure (OR, 1.5; 95% CI, 1.2-1.9), atrial fibrillation/flutter (OR, 1.3; 95% CI, 1.3-1.4), diabetes mellitus (OR, 1.2; 95% CI, 1.2-1.3), coronary artery disease (OR, 1.2; 95% CI, 1.2-1.3), anemia (OR, 1.4; 95% CI, 1.4-1.5), chronic obstructive pulmonary disease (OR, 1.4; 95% CI, 1.3-1.4), home with home healthcare disposition (OR, 1.5; 95% CI, 1.5-1.6), leaving against medical advice (OR, 1.7; 95% CI, 1.6-1.9), length of stay of 3 to 5 days (OR, 1.5; 95% CI, 1.4-1.6) or >5 days (OR, 2; 95% CI, 1.8-2), and having private insurance (OR, 0.6; 95% CI, 0.6-0.7). Conclusions The 30‐day readmission rate after syncope/collapse was 9.3%. We identified causes and risk factors associated with readmission. Future prospective studies are needed to derive risk‐stratification models to reduce the high burden of readmissions.

LanguageEnglish (US)
Article numbere009746
JournalJournal of the American Heart Association
Volume7
Issue number18
DOIs
StatePublished - Sep 1 2018

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Patient Readmission
Syncope
Cohort Studies
Odds Ratio
Confidence Intervals
Length of Stay
Hospitalization
Atrial Flutter
Sex Ratio
Insurance
Atrial Fibrillation
Chronic Obstructive Pulmonary Disease
Anemia
Coronary Artery Disease

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Causes and predictors of 30-day readmission in patients with syncope/collapse : A nationwide cohort study. / Kadri, Amer N.; Abuamsha, Hasan; Nusairat, Leen; Kadri, Nazih; Abuissa, Hussam; Masri, Ahmad; Hernandez, Adrian V.

In: Journal of the American Heart Association, Vol. 7, No. 18, e009746, 01.09.2018.

Research output: Contribution to journalArticle

Kadri, Amer N. ; Abuamsha, Hasan ; Nusairat, Leen ; Kadri, Nazih ; Abuissa, Hussam ; Masri, Ahmad ; Hernandez, Adrian V. / Causes and predictors of 30-day readmission in patients with syncope/collapse : A nationwide cohort study. In: Journal of the American Heart Association. 2018 ; Vol. 7, No. 18.
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abstract = "Background Syncope accounts for 0.6{\%} to 1.5{\%} of hospitalizations in the United States. We sought to determine the causes and predictors of 30‐day readmission in patients with syncope. Methods and Results We identified 323 250 encounters with a primary diagnosis of syncope/collapse in the 2013-2014 Nationwide Readmissions Database. We excluded patients younger than 18 years, those discharged in December, those who died during hospitalization, hospital transfers, and those whose length of stay was missing. We used multivariable logistic regression analysis to evaluate the association between baseline characteristics and 30‐day readmission. A total of 282 311 syncope admissions were included. The median age was 72 years (interquartile range, 58-83), 53.9{\%} were women, and 9.3{\%} had 30‐day readmission. The most common cause of 30‐day readmissions was syncope/collapse, followed by cardiac, neurological, and infectious causes. Characteristics associated with 30‐day readmissions were age 65 years and older (odds ratio [OR], 0.7; 95{\%} confidence interval [CI], 0.6-0.7), female sex (OR, 0.9; 95{\%} CI, 0.8-0.9), congestive heart failure (OR, 1.5; 95{\%} CI, 1.2-1.9), atrial fibrillation/flutter (OR, 1.3; 95{\%} CI, 1.3-1.4), diabetes mellitus (OR, 1.2; 95{\%} CI, 1.2-1.3), coronary artery disease (OR, 1.2; 95{\%} CI, 1.2-1.3), anemia (OR, 1.4; 95{\%} CI, 1.4-1.5), chronic obstructive pulmonary disease (OR, 1.4; 95{\%} CI, 1.3-1.4), home with home healthcare disposition (OR, 1.5; 95{\%} CI, 1.5-1.6), leaving against medical advice (OR, 1.7; 95{\%} CI, 1.6-1.9), length of stay of 3 to 5 days (OR, 1.5; 95{\%} CI, 1.4-1.6) or >5 days (OR, 2; 95{\%} CI, 1.8-2), and having private insurance (OR, 0.6; 95{\%} CI, 0.6-0.7). Conclusions The 30‐day readmission rate after syncope/collapse was 9.3{\%}. We identified causes and risk factors associated with readmission. Future prospective studies are needed to derive risk‐stratification models to reduce the high burden of readmissions.",
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T2 - Journal of the American Heart Association

AU - Kadri, Amer N.

AU - Abuamsha, Hasan

AU - Nusairat, Leen

AU - Kadri, Nazih

AU - Abuissa, Hussam

AU - Masri, Ahmad

AU - Hernandez, Adrian V.

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N2 - Background Syncope accounts for 0.6% to 1.5% of hospitalizations in the United States. We sought to determine the causes and predictors of 30‐day readmission in patients with syncope. Methods and Results We identified 323 250 encounters with a primary diagnosis of syncope/collapse in the 2013-2014 Nationwide Readmissions Database. We excluded patients younger than 18 years, those discharged in December, those who died during hospitalization, hospital transfers, and those whose length of stay was missing. We used multivariable logistic regression analysis to evaluate the association between baseline characteristics and 30‐day readmission. A total of 282 311 syncope admissions were included. The median age was 72 years (interquartile range, 58-83), 53.9% were women, and 9.3% had 30‐day readmission. The most common cause of 30‐day readmissions was syncope/collapse, followed by cardiac, neurological, and infectious causes. Characteristics associated with 30‐day readmissions were age 65 years and older (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6-0.7), female sex (OR, 0.9; 95% CI, 0.8-0.9), congestive heart failure (OR, 1.5; 95% CI, 1.2-1.9), atrial fibrillation/flutter (OR, 1.3; 95% CI, 1.3-1.4), diabetes mellitus (OR, 1.2; 95% CI, 1.2-1.3), coronary artery disease (OR, 1.2; 95% CI, 1.2-1.3), anemia (OR, 1.4; 95% CI, 1.4-1.5), chronic obstructive pulmonary disease (OR, 1.4; 95% CI, 1.3-1.4), home with home healthcare disposition (OR, 1.5; 95% CI, 1.5-1.6), leaving against medical advice (OR, 1.7; 95% CI, 1.6-1.9), length of stay of 3 to 5 days (OR, 1.5; 95% CI, 1.4-1.6) or >5 days (OR, 2; 95% CI, 1.8-2), and having private insurance (OR, 0.6; 95% CI, 0.6-0.7). Conclusions The 30‐day readmission rate after syncope/collapse was 9.3%. We identified causes and risk factors associated with readmission. Future prospective studies are needed to derive risk‐stratification models to reduce the high burden of readmissions.

AB - Background Syncope accounts for 0.6% to 1.5% of hospitalizations in the United States. We sought to determine the causes and predictors of 30‐day readmission in patients with syncope. Methods and Results We identified 323 250 encounters with a primary diagnosis of syncope/collapse in the 2013-2014 Nationwide Readmissions Database. We excluded patients younger than 18 years, those discharged in December, those who died during hospitalization, hospital transfers, and those whose length of stay was missing. We used multivariable logistic regression analysis to evaluate the association between baseline characteristics and 30‐day readmission. A total of 282 311 syncope admissions were included. The median age was 72 years (interquartile range, 58-83), 53.9% were women, and 9.3% had 30‐day readmission. The most common cause of 30‐day readmissions was syncope/collapse, followed by cardiac, neurological, and infectious causes. Characteristics associated with 30‐day readmissions were age 65 years and older (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6-0.7), female sex (OR, 0.9; 95% CI, 0.8-0.9), congestive heart failure (OR, 1.5; 95% CI, 1.2-1.9), atrial fibrillation/flutter (OR, 1.3; 95% CI, 1.3-1.4), diabetes mellitus (OR, 1.2; 95% CI, 1.2-1.3), coronary artery disease (OR, 1.2; 95% CI, 1.2-1.3), anemia (OR, 1.4; 95% CI, 1.4-1.5), chronic obstructive pulmonary disease (OR, 1.4; 95% CI, 1.3-1.4), home with home healthcare disposition (OR, 1.5; 95% CI, 1.5-1.6), leaving against medical advice (OR, 1.7; 95% CI, 1.6-1.9), length of stay of 3 to 5 days (OR, 1.5; 95% CI, 1.4-1.6) or >5 days (OR, 2; 95% CI, 1.8-2), and having private insurance (OR, 0.6; 95% CI, 0.6-0.7). Conclusions The 30‐day readmission rate after syncope/collapse was 9.3%. We identified causes and risk factors associated with readmission. Future prospective studies are needed to derive risk‐stratification models to reduce the high burden of readmissions.

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