Hospital Readmission in Patients With Spontaneous Coronary Artery Dissection
Chayakrit Krittanawong1, Bing Yue2, Dhruv Mahtta1
1Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, Texas.
Insights
Nearly 11% of spontaneous coronary artery dissection (SCAD) patients face 30-day hospital readmission, often due to cardiac issues like acute coronary syndrome or chest pain. Identifying high-risk SCAD patients may prevent readmissions.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- Spontaneous coronary artery dissection (SCAD) is a significant cause of acute coronary syndrome, particularly in women without traditional atherosclerotic risk factors.
- SCAD can manifest with diverse clinical presentations, including chest pain, syncope, and sudden cardiac death.
Purpose of the Study:
- To investigate the incidence, causes, and predictors of 30-day hospital readmission among patients diagnosed with SCAD.
- To identify common cardiac-related reasons for early readmission after an initial SCAD hospitalization.
Main Methods:
- A contemporary analysis utilizing the Nationwide Readmissions Database (2016-2017).
- Identification of patients with a primary discharge diagnosis of SCAD.
- Assessment of 30-day readmission rates and primary causes for readmission.
Main Results:
- Out of 795 SCAD patients, 85 (11.3%) were readmitted within 30 days.
- The majority of readmissions (57%) were cardiac-related.
- Common causes included acute coronary syndrome (27.3%), chest pain/unspecified angina (24.6%), heart failure (17.5%), and recurrent SCAD (8.3%).
Conclusions:
- A substantial proportion of SCAD patients require readmission within 30 days, primarily for cardiac reasons.
- Risk stratification and targeted management strategies are crucial for preventing SCAD readmissions and reducing healthcare costs.
- Further research is needed to validate these findings and refine management protocols.
Abstract:
Spontaneous coronary artery dissection (SCAD) can present with various clinical symptoms, including chest pain, syncope, and sudden cardiac death, particularly in those without atherosclerotic risk factors. In this contemporary analysis, we aimed to identify the causes and predictors of 30-day hospital readmission in SCAD patients. We utilized the latest Nationwide Readmissions Database from 2016 - 2017 to identify patients with a primary discharge diagnosis of SCAD. The primary outcome was 30-day readmission. Among 795 patients admitted with a principal discharge diagnosis of SCAD, 85 (11.3%) were readmitted within 30 days of discharge from index admission (69.8% women, mean age of 54.3 ± 0.8). More than half of the readmissions (57%) were cardiac-related readmissions. Common cardiac causes for 30-day hospital readmission were acute coronary syndrome (27.3%), chest pain/unspecified angina (24.6%), heart failure (17.5%), and recurrent SCAD (8.3%). In conclusion, we found that following hospitalization for SCAD, almost one-tenth of patients were readmitted within 30 days, largely due to cardiac cause . Risk stratifying patients with SCAD, identifying high-risk features or atypical phenotypes of SCAD, and using appropriate management strategies may prevent hospital readmissions and reduce healthcare-related costs. Further studies are warranted to confirm these causes of readmission in SCAD patients.
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