Risk Factors for 30-day Hospital Readmissions After Peripheral Vascular Interventions in Peripheral Artery Disease Patients at the US-Mexico Border

• Published in: Angiology Vol. 75; no. 3; pp. 240 - 248
• Main Authors: Mishra, Kunal, Mohammad, Khan O., Patel, Divyank, Makhija, Rakhee, Siddiqui, Tariq, Abolbashari, Mehran, Cruz Rodriguez, Jose B.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-03-2024
• Subjects: readmission rates; peripheral artery disease; critical limb ischemia; peripheral angiographic intervention; US-Mexico border
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/00033197221146161

Peripheral artery disease (PAD) is associated with high rates of readmission following endovascular interventions and contributes to a significant hospital readmission burden. Quality metrics like hospital readmissions affect hospital performance, but must adjust to local trends. Our primary goal was to evaluate risk factors and readmission rates post-percutaneous peripheral intervention in a US-Mexico border city, at a single tertiary university hospital. We performed a retrospective review of patients with PAD undergoing first time peripheral intervention from July 2015 to June 2020. Among 212 patients, 58% were readmitted with median 235-day follow-up (inter-quartile range (IQR) 42–924); 35.3% of readmissions occurred within 30 days, and 30.2% of those were within 7 days. Median time to readmission was 62 days. Active smokers had 84% higher risk of readmission (hazard ratio (HR) 1.84, 95% CI 1.23–2.74, P < .01). Other significant factors noted were insurance status—Medicaid or uninsured (HR 1.94, 95% CI 1.22–3.09), prior amputation (HR 1.69, 95% CI 1.13–2.54), heart failure, both preserved (HR 4.35, 95% CI 2.07–9.16) and reduced ejection fraction (HR 1.88, 95% CI 1.14–3.10). Below the knee, interventions were less likely to be readmitted (adjusted HR .64, 95% CI 0.42–.96). Readmission rates were unrelated to medication adherence.