ArticleJournal of the American College of Cardiology2015
Readmissions after carotid artery revascularization in the Medicare population.
Article in Journal of the American College of Cardiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Do postoperative telemedicine interventions with a communication feature reduce emergency department visits and readmissions?-a systematic review and meta-analysis.Surgical endoscopy · 2021Pooled it
- Unplanned readmission after carotid stenting versus endarterectomy: analysis of the United States Nationwide Readmissions Database.Journal of neurointerventional surgery · 2023Article
- High incidence of potentially preventable emergency department visits after major elective colorectal surgery.Surgical endoscopy · 2022Article
- Accurate classification of carotid endarterectomy indication using physician claims and hospital discharge data.BMC health services research · 2022Article
- Predictors of 30-Day Unplanned Readmission After Carotid Artery Stenting Using Artificial Intelligence.Advances in therapy · 2021Article
- Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.Circulation · 2021Article
- Risk factors associated with 30-day hospital readmission after carotid endarterectomy.Vascular · 2021Article
- Identifying Populations at Risk for Child Abuse: A Nationwide Analysis.Journal of pediatric surgery · 2020Article
- Examining variation in Medicare payments and drivers of cost for carotid endarterectomy.The Journal of surgical research · 2018Article
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8 authors.
Funding
Abstract
backgroundIn appropriately selected patients with severe carotid stenosis, carotid revascularization reduces ischemic stroke. Prior clinical research has focused on the efficacy and safety of carotid revascularization, but few investigators have considered readmission as a clinically important outcome.
objectivesThe aims of this study were to examine frequency, timing, and diagnoses of 30-day readmission following carotid revascularization; to assess differences in 30-day readmission between patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS); to describe hospital variation in risk-standardized readmission rates (RSRR); and to examine whether hospital variation in the choice of procedure (CEA vs. CAS) is associated with differences in RSRRs.
methodsWe used Medicare fee-for-service administrative claims data to identify acute care hospitalizations for CEA and CAS from 2009 to 2011. We calculated crude 30-day all-cause hospital readmissions following carotid revascularization. To assess differences in readmission after CAS compared with CEA, we used Kaplan-Meier survival curves and fitted mixed-effects logistic regression. We estimated hospital RSRRs using hierarchical generalized logistic regression. We stratified hospitals into 5 groups by their proportional CAS use and compared hospital group median RSRRs.
resultsOf 180,059 revascularizations from 2,287 hospitals, CEA and CAS were performed in 81.5% and 18.5% of cases, respectively. The unadjusted 30-day readmission rate following carotid revascularization was 9.6%. Readmission risk after CAS was greater than that after CEA. There was modest hospital-level variation in 30-day RSRRs (median: 9.5%; range 7.5% to 12.5%). Variation in proportional use of CAS was not associated with differences in hospital RSRR (range of median RSRR across hospital groups 9.49% to 9.55%; p = 0.771).
conclusionsAlmost 10% of Medicare patients undergoing carotid revascularization were readmitted within 30 days of discharge. Compared with CEA, CAS was associated with a greater readmission risk. However, hospitals' RSRR did not differ by their proportional CAS use.
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