Navigation Links
Angioplasty Patients May Be at Risk for Rehospitalization
Date:11/29/2011

By Denise Mann
HealthDay Reporter

MONDAY, Nov. 28 (HealthDay News) -- About one in 10 people who have angioplasty to open blocked heart arteries will land back in the hospital within 30 days, a new study indicates.

And a second, related report found that rehospitalization after angioplasty or stent placement remains a risk even three years after the procedure.

Both studies, which appear in the Nov. 28 issue of the Archives of Internal Medicine, highlight the need for better methods of identifying and treating high-risk individuals.

In the first study of more than 15,000 people who had either a balloon angioplasty or stent placement to open up their blocked heart arteries, 9.4 percent of the patients were readmitted to the hospital within 30 days. What's more, these individuals were more likely to die within a year when compared with their counterparts who were not readmitted to the hospital after their procedure. Females, individuals with unstable angina (chest pain) and those with Medicare insurance were among the most likely to be rehospitalized after their procedure, the results showed.

"I wouldn't have thought the rehospitalization rate would be that high, but it gives us an opportunity to study those factors that we could change," said study author Dr. David Holmes, a cardiologist at Mayo Clinic in Rochester, Minn.

Many of the factors that increase risk of rehospitalization can't be changed, but others can be addressed.

"Maybe people with lower education levels can't follow instructions, so maybe we need to change how we provide information so that they go out understanding what medications they need to take and what the warning signs are that should make them come back," Holmes explained.

"Coronary artery disease is a chronic condition that needs chronic care," he said. "Just because a stent is placed or bypass surgery is done does not mean that you don't need continued care in terms of preventing other episodes. You have the disease and have been treated for this episode. Now we need to treat the rest of you to decrease the chance that you will have another episode in the course of this chronic and progressive disease."

The second study looked at the readmission rate among 11,118 patients from an Italian heart registry. After three years, they had a 7 percent to 20 percent rate of hospital readmission. The 7,867 rehospitalizations were for new procedures to open arteries, heart failure, heart attack or serious bleeds.

"Hospital admissions are frequent, both in the first year and in the following years after," said study author Dr. Gianluca Campo, a cardiologist at the Azienda Ospedaliera-Universitaria di Ferrara in Ferrara, Italy. "The most dangerous adverse events are heart failure and bleeding events. These complications have a strong negative impact on long-term mortality."

Earlier identification of individuals who are at high risk for readmission after angioplasty or other cardiovascular procedures is key, said Dr. Adrian F. Hernandez, a cardiologist at Duke University who co-authored an editorial accompanying the new studies. Much of this onus falls on the hospitals that treat and release these patients, he said. "Understand the holes in your system: Do you even know your readmission rates, and can you develop metrics around readmission?" he asked.

Also, "identify the barriers in transitions of care: Do patients have the right information when they walk out the door? Do they know who to call with problems? Do they have their medications? Do they have appropriate follow-up scheduled? Can they get to the appointment?," Hernandez asked. "Follow-up ideally within seven to 10 days with a generalist or cardiologist is suitable."

Certain factors that may place a patient at high risk for rehospitalization include having several other medical problems such as heart failure, kidney disease or lung disease. "Emergent or urgent angioplasty is also higher risk, [and] whether the procedure was considered a success or whether it was complicated may influence the risk of having problems after discharge," Hernandez added.

"Of the variables identified as being independently associated with 30-day rehospitalization, the vast majority are not modifiable," said Dr. Gregg C. Fonarow, associate chief of cardiology at the University of California at Los Angeles. "Further studies are needed to determine if any of the readmissions are preventable, and that preventing readmission would reduce mortality."

More information

What is angioplasty? Find out at the U.S. National Heart, Lung, and Blood Institute.

SOURCES: David Holmes, M.D., cardiologist, Mayo Clinic, Rochester, Minn.; Adrian F. Hernandez, M.D., MHS, Duke University, Durham, N.C.; Gianluca Campo, M.D., cardiologist, the Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy; Gregg C. Fonarow, M.D., associate chief, cardiology, University of California at Los Angeles; Nov. 28, 2011, Archives of Internal Medicine


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. South Asian patients require 3 times as much repeat angioplasty as white Europeans
2. Patients fare just as well if their nonemergency angioplasty is performed at hospitals
3. Women No More Likely to Die After Angioplasty
4. Heart Attack Damage Not Reduced by Adding Balloon Pump to Angioplasty
5. Study shows balloon pump use prior to angioplasty does not reduce heart muscle damage
6. Most Heart Attack Patients Who Need Angioplasty Quickly Get It: Study
7. Adherence to Angioplasty/Stent Guidelines Lacking: Study
8. Angioplasty with stents may be safe in long-term for low-risk heart patients
9. Angioplasty may be feasible for liver transplantation candidates with heart disease
10. Cardiac Rehab Can Boost Survival After Angioplasty, Study Finds
11. Elevated protein levels in cardiac muscles could predict mortality following angioplasty
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Angioplasty Patients May Be at Risk for Rehospitalization
(Date:5/5/2016)... ... May 05, 2016 , ... Textile Exchange is excited to announce ... stakeholder review. The stakeholder review is an important opportunity for interested parties to give ... value to the wool industry., The RWS is intended to be a global benchmark ...
(Date:5/5/2016)... Diego, CA (PRWEB) , ... May 05, 2016 , ... ... dashboard and dedicated Twitter feed to cover the latest news and commentary at the ... through 10th. This meeting of the American Society of Cataract and Refractive Surgery and ...
(Date:5/5/2016)... ... 2016 , ... TLC Laser Eye Centers announced today that it has acquired ... now be called “Gordon Schanzlin New Vision Institute, a TLC Laser Eye Center.” ... to ensure that patients continue to receive the highest quality of care. In addition, ...
(Date:5/5/2016)... ... May 05, 2016 , ... Spring Fertility , ... IVF and with egg freezing, today announced the grand opening of its first ... fertility care, Spring Fertility offers both fertility preservation (egg, sperm, embryo, and testicular ...
(Date:5/5/2016)... ... May 05, 2016 , ... ... Seminars for Business Journalists , led by the Wharton School’s most prominent ... issues.  This one-day program at the Wharton School’s San Francisco campus will ...
Breaking Medicine News(10 mins):
(Date:5/5/2016)... Global NASH market report ... rise in obesity will fuel the demand for ... years. The NASH Market is growing at a ... of rising number of obesity among young population. ... with no FDA approved therapeutics. Antioxidants, anti-diabetic medications, ...
(Date:5/5/2016)... , May 5, 2016  Replikins Ltd. today reported initial promising results in animal ... Photo - http://photos.prnewswire.com/prnh/20160505/364345 ... ... ... of all Zika specimens recorded on Pubmed. The analysis identified the highest gene Replikin ...
(Date:5/5/2016)... , May 5, 2016  Endo International ... today announced that Brian Lortie , President, ... from his position upon the appointment of a ... led its U.S. Pharmaceuticals business with responsibility for ... and marketing, strategy and portfolio development, commercial operations, ...
Breaking Medicine Technology: