Abstract 01: Thirty-day Readmission Rate For Hypertensive Crisis: A Nationwide Analysis

Abstract

Objective: Hypertensive crisis is a life-threatening condition that leads to poor patient outcomes if not treated urgently. We evaluate the all-cause 30-day readmission rate, resource utilization, predictors of readmission, and the most common causes for readmission in patients admitted with hypertensive crisis. Methods: Using the National Readmission Database 2018, patients ≥18 years of age admitted with the principal diagnosis of the hypertensive crisis were included in the study. The primary outcome was the all-cause 30-day readmission rate in these patients. Results: We identified 129,239 patients as index admissions. The mean age of index patients was 61±0.14 years, and females were 56.6%. The 30-day readmission rate was 10.6 % (13,768± 355). The in-hospital mortality rate was 0.2 % for index admissions and 1.5 % for readmissions. The cumulative length of stay (LOS) for all readmitted patients was 62,046± 1,802 days. The cumulative total cost of hospital services in readmitted patients was 155 ± 4.6 million USD. Age<65, lower-income, increased LOS, increased comorbidity burden, primary payer, and disposition were important predictors of readmission (Table). The most common causes of readmission were hypertensive crisis (19 %), CHF (12.4%), acute renal failure (4.4%), sepsis (2.6%), ESRD (2%), NSTEMI (2%), and stroke (1.7%) Conclusion: In conclusion, the 30-day readmission rate in patients with hypertensive crisis is high (10.6%), with hypertensive crisis and CHF as the most common causes. Resource utilization is also high, with many potential avoidable days and costs. Future strategies should address underlying factors, especially socioeconomic factors.