Length of Stay, Charges and Causes of Readmission
Patients who were readmitted were more likely to have a longer length of
stay during the index admission (2.8 days ± 4.8 vs 1.5 ± 2.7 days,
p<0.001). Total charges accrued during the index admission
were also different ($139,869.3 ± 94,574.3 vs $115,358 ± 72,523.8,
p<0.001). The average length of stay for a rehospitalization
was 4.8 days ±4.9 days and the average charge of rehospitalization was
$62,577± 85,850 (Table 1). Broadly speaking, the top categories for
readmissions included: cardiac (26.36%), gastrointestinal (26.33%) and
pulmonary (12.36%) (Figure 3). More specifically, atrial fibrillation
and atrial flutter (8.23%) and congestive heart failure (8.23%) were
both equal in frequency as the primary causes of readmission, followed
by gastrointestinal diseases (7.41%), sepsis (6.17%), diverticular
disease (3.70%), vascular disorders of the intestine (3.29%), acute
kidney failure (3.29%), hypertensive heart and chronic kidney disease
(2.47%), respiratory failure (2.47%), other cardiac arrhythmias
(2.06%), and COPD (2.06%) (Table 2). The ICD 10 category containing
gastrointestinal diseases includes hematemesis and melena. Importantly,
cerebral infarction represented the cause for 1.23% of readmissions and
transient ischemic attacks represented 0.41% of readmissions. A top ten
list of causes of readmission is displayed in Table 2. The mortality
rate during readmission was 1.2%.
Figure 3. Broad categories for primary diagnosis of 30-day LAAC
readmissions