Analysis of Risk Factors Associated with Hospital Readmission Within 6 Months After PCI Treatment for Patients with Aacute Coronary Syndrome and Diabetes
YIN Yuhua, et al
Chengde Central Hospital, Hebei Chengde 067000, China
Abstract:Objective: To analysize the risk factors associated with re-admission within 6 months after percutaneous coronary intervention for patients with acute coronary syndrome and diabetes, and to provide a reliable basis for improving the quality of life and prognosis of patients. Method: A total of 300 patients were selected, who were diagnosed with ACS and diabetes in our hospital from May 2019 to November 2021 and undergone percutaneous coronary intervention. According to whether the patients had unplanned readmissions 6 months after surgery, they were divided into a control group (216 cases, no re-admission to hospital) and a study group (84 cases, re-admitted). The patient’s age, disease history, medication history, laboratory test results, vascular disease and other clinical data were analyzed retrospectively. Reasons for admission and risk factors were analyzed. Results: Reasons for re-admission of 84 patients in the study group: 27 cases of chest pain (32.14%), 21 cases of chest tightness (25.00%), 9 cases of acute myocardial infarction (10.71%), 9 cases of pulmonary infection (10.71%) %), 6 cases of unstable angina (7.14%), 6 cases of heart failure (7.14%), and 6 cases of other reasons (7.14%); re-admission time: 18 (21.43%) readmissions in ≤30 days, 30 (35.71%) readmissions in 31-60 days and 36 (42.86%) readmissions in ≤180 days; the study involved 300 subjects, of which the 84 cases in the study group were treated twice or more ( readmission rate, 28.00%); univariate analysis showed obvious statistical difference on items of age, myocardial infarction, angina pectoris, preoperative blood glucose, smoking history, low-density lipoprotein cholesterol, ECG ST segment changes, Gensini score, and aspirin(P<0.05); Logistic multivariate regression analysis verified that age (OR=1.480, 95%cl:1.077 -2.033), myocardial infarction (OR=4.91, 95%cl: 1.52-15.98), angina (OR=1.679, 95%cl: 1.023-2.738), smoking history (OR=1.001, 95%cl: 1.000-1.002) , LDL (OR=2.327, 95%Cl: 2.003-3.018), ECG ST segment changes (OR=3.81, 95%Cl: 1.94-4.470), Gensini score (OR=1.580, 95%Cl: 1.166-2.140)were all independent risk factors for readmission of ACS patients within 6 months after PCI. Conclusion: Age, myocardial infarction, angina pectoris, smoking history, LDL, ECG ST segment change score, and Gensini score are independent risk factors for readmission within 6 months after percutaneous coronary intervention(PCI) in patients with ACS and diabetes mellitus. Early intervention with secondary prevention measures is expected to reduce the incidence of readmissions, thereby improving the quality of life of patients.
[1] 李镒冲,刘世炜,曾新颖,等.1990年至2016年中国及省级行政区心血管病疾病负担报告[J].中国循环杂志,2019,34(8):729-740. [2] Hansen K N,Bendix K,Antonsen L,et al.1-year rehospitalization after percutaneous coronary intervention:a retrospective analysis[J].Eurointervention Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology,2018,5(1):12-18. [3] 王雅,程继芳,刘重斌,等.经皮冠状动脉介入治疗后患者早期再入院的研究进展[J].中华护理杂志,2020,55(10):1598-1600. [4] 尉驰.急性冠状动脉综合征患者经皮冠状动脉介入治疗术后6个月内再入院相关危险因素分析与评价[D].西安,空军军医大学,2019. [5] 葛均波,徐永健,王辰.内科学[M].第9版.北京:人民卫生出版社,2018.234-245. [6] 徐亮,杨松,陈燕春,等.血糖控制水平对糖尿病患者冠状动脉微循环阻力指数的影响[J].东南大学学报(医学版),2018,37(2):315-319. [7] 尉驰,袁平年,郭文怡.急性冠状动脉综合征患者经皮冠状动脉介入治疗术后6个月内再入院危险因素分析[J].中国心血管杂志,2019,24(3):218-222. [8] 姚文森.急性ST段抬高型心肌梗死患者急诊PCI后因主要不良心脏事件再入院的相关影响因素及临床特征分析[D].吉林:吉林大学,2019.