Abstract 16255: Acute Pericarditis Related Hospitalization and Readmission in the United States

Abstract

Introduction: Acute pericarditis accounts for one in every twenty emergency department visits for chest pain and a majority of these patients get admitted to a hospital. However, apart from small studies, there is a lack of data regarding the incidence and predictors of readmissions in these patients. Methodology: A secondary analysis of the Nationwide Readmission Database for years 2016-2017 was performed. Patients who were admitted with a primary diagnosis of acute pericarditis in the first six months of each year were identified based on International Classification of Diseases (ICD-10), Clinical Modification codes, and were followed for 180 days. A multivariate cox-regression model was utilized to delineate the predictors of pericarditis related readmissions. Results: A total of 21,115 patients were admitted with a primary diagnosis of acute pericarditis. The mean age was 53.3+19 years and 60.83% were males. About 23% of patients had pericardial effusion or tamponade and 19.4% of patients presenting with pericarditis required pericardiocentesis. The mortality rate during index admission was 3.21% and the mean length of stay was 6.4+9 days. The rate of all-cause readmission was 30.8% within 180 days, of which 23.8% were pericarditis related. The mean time to readmission for pericarditis was 37.7+41 days. Females were at higher risk of readmission for pericarditis [OR 1.66, CI (1.38-1.99), p<0.001] after adjustment for multiple variables (including connective tissue disease, congestive heart failure and malignancy). Presence of comorbidities like diabetes mellitus [HR 1.21, CI(1.01-1.45), p=0.04], obesity [HR 1.27, CI(1.05-1.54), p=0.01], and chronic lung disease [HR 1.32, CI(1.12-1.57), p=0.001] also increased risk of pericarditis related readmissions. Moreover, the length of index hospitalization was significantly higher in patients with pericarditis related readmissions [5.4+6 vs1.6+5 days, p<0.001]. Conclusion: Even though the mortality during index admission in patients admitted with pericarditis is low, about 1 in every 3 patients will be readmitted within 180 days. While females account for a minority of initial admissions for pericarditis, their risk of readmission is significantly higher.