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Almost One in 10 Readmitted After Carotid Revascularization

Risk of readmission greater after carotid artery stenting than carotid endarterectomy

FRIDAY, April 10, 2015 (HealthDay News) — Almost one in 10 Medicare patients undergoing carotid revascularization are readmitted within 30 days, according to a study published in the April 14 issue of the Journal of the American College of Cardiology.

Mohammed Salim Al-Damluji, M.D., M.P.H., from Yale University in New Haven, Conn., and colleagues examined the frequency, timing, and diagnoses of 30-day readmission after carotid revascularization. Medicare fee-for-service administrative claims data were used to identify acute care hospitalizations for carotid endarterectomy (CEA) and carotid artery stenting (CAS) from 2009 to 2011. The authors compared the differences in readmission after CEA and CAS. Data were included for 180,059 revascularizations from 2,287 hospitals, with CEA and CAS performed in 81.5 and 18.5 percent of cases, respectively.

The researchers found that after carotid revascularization, the unadjusted readmission rate was 9.6 percent. The risk of readmission was greater after CAS than after CEA. Modest hospital-level variation was seen in 30-day risk-standardized readmission rates (mean, 9.5 percent; range, 7.5 to 12.5 percent). There was no correlation between variation in proportional use of CAS and differences in hospital risk-standardized readmission rates (P = 0.771).

“One in 10 Medicare patients undergoing carotid revascularization is readmitted within 30 days,” the authors write. “The present study is in large part foundational, raising awareness among clinicians, hospital administrators, and policymakers regarding this issue and illustrating the extent to which readmission rates differ by the type of revascularization procedure.”

One author disclosed financial ties to Medtronic.

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