Thirty-day readmission rate among patients with hypertensive crisis: A nationwide analysis

Authors

Muddasir Ashraf, Hospital Medicine, UnityPoint Health Clinic Quad Cities, Rock Island, Illinois.Follow
Viviana Zlochiver, Advocate Aurora HealthFollow
Alexander Bolton, University of Iowa College of Public Health, Iowa City, Iowa.
Suhail Q. Allaqaband, Advocate Aurora HealthFollow
Tanvir Bajwa, Advocate Aurora HealthFollow
M Fuad Jan, Advocate Aurora HealthFollow

Recommended Citation

Ashraf M, Zlochiver V, Bolton A, Allaqaband SQ, Bajwa T, Jan MF. Thirty-Day Readmission Rate Among Patients With Hypertensive Crisis: A Nationwide Analysis. Am J Hypertens. 2022;35(10):852-857. doi:10.1093/ajh/hpac088

Affiliations

Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers

Abstract

BACKGROUND: Hypertensive crisis is a life-threatening condition, further classified as hypertensive emergency and hypertensive urgency based on the presence or absence of acute or progressive end-organ damage, respectively. Readmissions in hypertensive emergency have been studied before. We aimed to analyze 30-day readmissions using recent data and more specific ICD-10-CM coding in patients with hypertensive crisis. METHODS: In a retrospective study using the National Readmission Database 2018, we collected data on 129,239 patients admitted with the principal diagnosis of hypertensive crisis. The primary outcome was the all-cause 30-day readmission rate. Secondary outcomes were common causes of readmission, in-hospital mortality, resource utilization, and independent predictors of readmission. We also compared outcomes between patients with hypertensive urgency and hypertensive emergency. RESULTS: Among 128,942 patients discharged alive, 13,768 (10.68%) were readmitted within 30 days; the most common cause of readmission was hypertensive crisis (19%). In-hospital mortality for readmissions (1.5%) was higher than for index admissions (0.2%, P<0.01). Mean length of stay for readmissions was 4.5 days. Mean hospital costs associated with readmissions were $10,950, and total hospital costs were $151 million. Age <65 years and female sex were independent predictors of higher readmission rates. Subgroup analysis revealed a higher readmission rate for hypertensive emergency than hypertensive urgency (11.7% vs. 10%, P<0.01). CONCLUSIONS: All-cause 30-day readmission rates are high in patients admitted with hypertensive crisis, especially patients with hypertensive emergency. Higher in-hospital mortality and resource utilization are associated with readmission in these patients.

Type

Article

PubMed ID

35869656