Abstract 113: Readmission Rates and Causes for In-Hospital Cardiac Arrest Survivors at 30 and 180 Days: Insights from Nationwide Readmission Database

Abstract

Introduction: Rates of survival to discharge for patients with in-hospital cardiac arrest (IHCA) have improved over the past 2 decades from 13% in 2000 to 25% in 2016. Yet, little is known about rates and causes of readmissions among those survivors. We sought to investigate early and late rates and causes of readmission for IHCA survivors at 30 and 180 days after discharge. Methods: Within the Nationwide Readmission Database (NRD), we identified patients 18 years of age or older who survived to hospital discharge after an IHCA between 2010 and 2016. IHCA was defined by an ICD-9 or ICD-10 diagnosis code (cardiac arrest, ventricular fibrillation or flutter) combined with a procedure code (defibrillation or external chest compression). We evaluated rates and causes of 30 and 180 days readmission and examined whether these have changed over time. Results: A total of 86,140 patients had an IHCA and survived to hospital discharge. Overall, mean age was 64.3 ± 14.9, women were 40.1%, and the mean length of stay was 15.1 ±17.9 days. All-cause readmission rates at 30 and 180 days were 22.7% and 69.9%, respectively. Readmission rates decreased over time. Thirty-day readmission rates decreased from 23.8% in 2010 to 21.1% in 2016, and 180-day readmission rates decreased from 76.1% to 63.6%. (Figure) Among readmitted patients, 13.5% were readmitted more than once at 30 days and 44.9% were readmitted more than once at 180 days. The most common cause of 30-day readmissions were congestive heart failure (11.7%), infection/septicemia (11.4%), and cardiac dysrhythmias (5.3%),whereas the top causes of 180-day readmissions were congestive heart failure (11.9%), infection/septicemia (11.3%), and respiratory insufficiency, or device complications (4.6%). Conclusion: All-cause readmission rates for IHCA survivors at 30 and 180 days have decreased over time, Congestive heart failure is the most common cause of readmissions but accounts for only 11.7% and 11.9% of readmissions at 30 and 180 days.