Abstract: FR-PO568
Thirty Day Readmissions in Patients Admitted for Hypertensive Emergency
Session Information
- Hypertension: Clinical and Translational
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Hypertension
- 1106 Hypertension: Clinical and Translational - Secondary Causes
Authors
- Saha, Aparna, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Chan, Lili, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Poojary, Priti, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Chauhan, Kinsuk, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Nadkarni, Girish N., Icahn School of Medicine at Mount Sinai, New York, New York, United States
Background
Hypertensive (HTN) emergency accounted for 111/100,000 hospital readmissions in 2007 with increasing incidence. Few studies have examined 30-day readmission rates, reasons and outcomes in this growing population
Methods
Utilizing the Nationwide Readmission Database from year 2013, admissions for HTN emergency were queried by combining ICD-9 codes for malignant HTN and acute target organ damage. We excluded patients on dialysis, those<18 years old and admission occurring in December due to lack of 30 day follow up for readmissions. Index admissions were any admission without a preceding 30 day admission,while readmissions were any admission that followed a prior admission by less than 30 days
Results
In 2013, 30,936 index admissions were identified.15.4% of all index admissions had at least one 30-day readmission. When stratified by chronic kidney disease stage 3 or higher(CKD3) status, patients with CKD3 had higher readmission rate,17% vs 14%,P<0.001.Of all index admissions,44.8% were complicated by acute kidney injury(AKI) and AKI had higher rates of readmissions,17% vs 14%,P<0.001.The top 10 causes for readmission are in Figure 1.While only 14% of readmissions were for repeat HTN emergency,50% of all readmissions were likely related to complications from HTN emergency(congestive heart failure,HTN with complications,AKI,acute cerebrovascular disease and acute myocardial infarction).In-hospital mortality during index admission was 3%,while on readmission it was 4%
Conclusion
Over 1 out of 10 index admission for HTN emergency is followed by 30-day readmission. A high percentage of readmissions were for repeat HTN emergency. Both AKI and CKD are associated with higher readmission rates. Efforts should be directed towards identifying effective measures to improve blood pressure control and better follow-up post hospitalization, particularly in those with kidney disease