Abstract 16892: Impact of Catheter-Directed Thrombolysis on Hospital Readmission Rates in Patients With Acute Proximal and Caval Deep Vein Thrombosis

Abstract

Objective: To evaluate the readmission rate and identify the predictors of rehospitalization in patients with acute proximal and caval DVT. Background: Acute Deep Vein Thrombosis (DVT) is a significant cause of mortality and morbidity in the US that affects more than 600,000 patients each year. Catheter-directed thrombolysis (CDT) is a minimally invasive treatment option that improve acute symptoms as well as quality of life of patients with acute DVT. Methods: Patients with index hospitalization for acute proximal and caval DVT between 2016 and 2017 in the U.S. Nationwide Readmission Database were evaluated for the rates, predictors, and costs of unplanned readmission at 30 days. We used Cox proportional hazard model to determine predictors of 30 days readmissions. Results: This analysis included 58,306 patients (age>=18 years) with index hospitalization for acute proximal and caval DVT; 8589 (14.7%) were readmitted within 30 days. The significant predictors for 30 day unplanned readmission were Malignancy (HR 1.60, 1.41-1.81), Charlson comorbidity index > 3 (HR 1.43, 1.30-1.57), Insurance Medicare vs Private(HR 1.39, 1.25-1.57), Length of stay more than 2 days (HR 1.34, 1.24-1.45), and Acute Kidney Injury (HR 1.28, 1.17-1.40), COPD (HR 1.25, 1.13-1.38), Age (HR 0.77,0.70-0.85), Catheter directed thrombolysis ( HR 0.83, 0.76-0.90), and Acute Pulmonary Embolism(HR 0.83, 0.76-0.90)(Figure1). The cost of readmission was higher than index hospitalization ($ 56733 vs $ 47396). Conclusion: The 30 days readmission rate continue to be high in patients with acute DVT. Patient’s characteristics and comorbid conditions are predictors of readmission. Use of Catheter directed thrombolysis for treatment of acute DVT predicts reduced readmission risk.