The Risk Factors Of Unplanned Readmissions In Patients With Acute Coronary Syndrome Within 60 Days After PCI

Research Purpose:The purpose of this study is to identify the risk factors of unplanned readmission in patients with acute coronary syndrome(ACS)within 60 days after percutaneous coronary intervention(PCI).Research Methods:In this study,the clinical data of 1337 patients with ACS and PCI were collected retrospectively from November 1,2018 to October 31,2019 in a 3A general hospital in Hangzhou.According inclusion,exclusion and eliminate criteria,936 patients finally entered the study.According to whether unplanned readmission occurred within 60 days after PCI,patients were divided into readmission group(92 cases)and non-readmission group(844 cases).The hospital medical record system was used to collect patients’ medical record data.We analyzed the influence of patients’ age,disease history,medication history,laboratory data,vascular diseases and other factors on readmission and the clinical characteristics of readmitted patients.Epidate3.0 was used for data entry,and two people check the entry.SPSS23.0 was used for data analysis.Normal measurement data were expressed by mean±standard deviation,and comparison between groups was performed by t test.Non-normal measurement data were expressed by median and quantile,and comparison between groups is performed by nonparametric test.The counting data are expressed by frequency and rate(%),and the comparison between groups is made by Chi-square test.Whether readmission occurred was a dependent variable,and the risk factors were analyzed by Logistic regression analysis.P< 0.05 is statistically significant.Research Results:936 patients were included in this study,of which 92 patients had unplanned readmission within 60 days.The readmission rate was 9.8%.1.Reasons for readmission: 71 patients were readmitted for cardiac reasons.Including unstable angina pectoris 20 cases(28.17%),acute myocardial infarction 13 cases(18.31%),chest tightness 11 cases(15.49%),chest pain 7 cases(9.86%),coronary heart disease 7 cases(9.86%),heart failure 3 cases(4.23%),arrhythmia 2 cases(2.82%),old myocardial infarction 2 cases(2.82%),subacute myocardial infarction 1 case(1.42%)and other cardiac causes 5 cases(7.04%).21 patients were readmitted for non-cardiac reasons.Including diabetes 5 cases(23.81%),cold or fever 3 cases(14.29%),pleural effusion 2 cases(9.52%),drug side effects 2 cases(9.52%),and other non-cardiac reasons 9 cases(42.86%).2.In terms of general clinical data,compared with the patients without readmission,the readmitted patients were older(P=0.008),paid more at their own expense(P=0.014),were more diagnosed with STEMI and NSTEMI(P=0.013),had more emergency PCI(P=0.004),stayed longer in hospital(P<0.001),more Insulin history(P=0.005)and more diabetes history(P=0.007).3.In terms of laboratory examination data,compared with the patients without readmission,the readmitted patients had higher levels of neutrophils(P=0.016),CK-MB(P=0.002),serum glucose(P=0.015),serum creatinine(P=0.002),D-Dimer(P<0.001)and C-reactive protein(P=0.001),and lower levels of hemoglobin(P=0.033),serum sodium(P=0.011)and albumin(P<0.001).4.In terms of contrast media and surgery,compared with patients without readmission,the readmitted patients had higher ACEF score(P<0.001),more number of diseased vessels(P<0.001),more left main artery disease(P=0.014),more left circumflex artery disease(P=0.001),more right coronary artery disease(P<0.001),multivessel disease(P<0.001),and less operation time(P=0.040).5.Logestic regression analysis showed that longer hospitalization days(P=0.002),higher smoking index(P=0.013),multi-vessel disease(P<0.001),higher ACEF score(P=0.003)and diabetes mellitus(P=0.040)were independent risk factors for unplanned readmission of ACS patients 60 days after PCI.Research Conclusion:The increased number of days in hospital and smoking index,multiple vascular diseases,higher ACEF score and diabetes were independent risk factors of Unplanned Readmissions in Patients with Acute Coronary Syndrome within 60 days after PCI.