Abstract 14971: Rate of 30-Day Readmission and Economic Burden of End-Stage Renal Disease Patients Who Underwent Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Procedure for ST - Elevation Myocardial Infarction

Abstract

Introduction and Hypothesis: We sought to determine the 30-Day Readmission rate (30-DRr) of patients with End-Stage Renal Disease (ESRD) 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 ESRD after PCI and CABG procedure 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 and patient charge. Results: A total of 13,753 index hospitalization was observed with a mean age was 68.5 SD±12.9 years, and 60.4% of patients were males. The in-hospital mortality rate for index admission was 8.4% (1,153 of 13,753), while 30-DRr was 20.6% (2,596 of 12,600) (Figure 1). Among this group of readmitted patients (mean age was 66 SD±12.4 years, 59.6% of patients were males), the In-hospital mortality rate was 6.4% (166 of 2,596). However, observed 30-DRr among Non-ESRD patients 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. A healthcare economic burden of $214,000,000 among readmitted ESRD patients. Conclusions: Approximately 1 in 5 patients who underwent PCI and CABG procedure for STEMI with underlying ESRD had 30-DRr, with subsequent readmissions associated with healthcare spending. Readmission mortality was statistically lower than index mortality. ESRD patients are a vulnerable subset who will benefit from outpatient multidisciplinary care.