Abstract 14962: Rate of 30-Day Readmission and Economic Burden of Sickle Cell Disease Patients Who Underwent Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Procedure for ST Elevation Myocardial Infarction

Abstract

Introduction: Sickle cell disease (SCD) is an inherited disorder in which microvascular occlusion causes complications across multiple organ systems, including the heart. Heart problems are among the most common causes of death in people with SCD. Macrovascular complications can also transpire among SCD. Hypothesis: We sought to determine the 30-Day Readmission rate (30-DRr) of patients with SCD who underwent Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft (CABG) procedure for ST-Elevation Myocardial Infarction (STEMI) and its impact on mortality and healthcare utilization in the United States. Methods: Using the 2020 National Readmission Database, we conducted a retrospective analysis of patients with SCD after PCI and CABG for STEMI as a principal diagnosis according to ICD-10 codes. Readmission was the first admission to any hospital for any non-trauma diagnosis within 30 days of the index admission. The primary outcome was 30DRr, while secondary outcomes were readmission mortality rate and resource utilization defined by length of stay & patient charge. Results: 77 index hospitalization was observed with a mean age of 57.4 SD± 4.2 years, and 70.6 % were females. The in-hospital mortality rate for index admission was 6.5% (5 of 77), while 30-DRr was 20.8% (15 of 72) (Figure 1). Among this group of readmitted patients (mean age was 61.2 SD± 10.5 years, & 57% were males), In-hospital mortality rate was 13.3% (2 of 15). However, observed 30-DRr among Non-SCD was 9.02% (36,564 of 405,526), which is lower, as well as lower inpatient index and readmission mortality of 4.81% (19,507 of 405,426) and 4.83% (1,764 of 36,564) respectively. Conclusions: Approximately 1 in 5 patients who underwent PCI and CABG procedures for STEMI with underlying SCD had 30-DRr. Readmission mortality was higher compared to index mortality but was not statistically significant. SCD patients are a vulnerable subset who will benefit from outpatient multidisciplinary care.