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Stent Procedures Linked To High Hospital Readmission Rate

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Stent procedures have been linked to high readmission rates with about one out of every six patients readmitted to the hospital within one month of their original procedure.

Stents are tiny wire-mesh tubes used during heart surgery that prop arteries open after angioplasty, in which blockages are cleared. Some stents are manufactured with a drug coating meant to keep blood vessels from re-clogging.

According to The Atlantic, a study involved 40,000 patients undergoing the procedure in New York in 2007 and revealed that within 30 days of the original procedure, 16% (or one in six) required readmission, with most unplanned, said The Atlantic. About 1/5th were planned for a second procedure in the same month; most involved heart disease or failure or chest pain and one of three involved a repeat stent procedure. The readmission rate is higher-than-typical versus the one-in-ten rate reported at one Minnesota hospital in another published study in November. The researchers stated that, regardless of the exact number, the numbers are worrisome.

“In general, all the studies have shown that readmission rates after (stent procedures) are higher than what we would expect. It points to a national problem in general regarding readmission after a hospitalization,” said Dr. Adrian Hernandez, cardiologist at the Duke University School of Medicine, wrote The Atlantic, which noted that Hernandez was not involved in the research. The research was led by Edward Hannan of the University at Albany, State University of New York.

The Atlantic pointed out experts feel many rehospitalizations could be prevented with proper follow-up treatment; however, the study found that most risk factors—age, underlying illness—cannot be changed by improved health care. The researchers say cardiologists need to be aware of the procedures’ increased risks and ensure that precautions are taken to ensure no repeat hospitalizations occur, said The Atlantic.

The team said being older, female, diagnosed with an underlying disease, or having a longer or more complicated first procedure were all factors for rehospitalization. “The majority of the factors are not modifiable. For instance, you can’t change someone’s age, you can’t change someone’s gender,” Hernandez told Reuters Health. Dr. Joseph Cacchione, a Cleveland Clinic cardiologist, in his commentary published with the study in the journal JACC: Cardiovascular Interventions, said that being aware of the risk factors is critical for determining and minimizing repeat stays. “You could keep them a little longer” he said of at-risk patients “(or), depending on the circumstances, you could have more aggressive care coordination or home care,” The Atlantic reported.

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