Etiologies, predictors, and economic impact of readmission within 1 month among patients with takotsubo cardiomyopathy

Background Limited data exist on readmission among patients with takotsubo cardiomyopathy (TC), a commonly reversible cause of heart failure. Hypothesis We sought to identify etiologies and predictors for readmission among TC patients. Methods We queried the National Readmissions Database for 2013–2014 to identify patients with primary admission for TC using ICD‐9‐CM code 429.83. Patients readmitted to hospital within 1 month after discharge were further evaluated to identify etiologies, predictors, and resultant economic burden of readmission. Additionally, we analyzed readmission for TC at 6 months. Results We studied 5997 patients admitted with TC, of whom 1.2% experienced in‐hospital mortality. Median age was 67 years, with 91.5% being female. Among survivors, 10.3% were readmitted within 1 month; 25% of the initial 1‐month readmissions occurred within 4 days, 50% within 10 days, and 75% within 20 days from discharge. The most common etiologies for readmission were cardiac (26%), respiratory (16%), and gastrointestinal (11%) causes. Heart failure was the most common cardiac etiology. Significant predictors of increased 1‐month readmission included systemic thromboembolic events, length of stay ≥3 days, and underlying psychoses. Obesity and private insurance predicted lower 1‐month readmission. The annual national cost impact for index admission and 1‐month readmissions was ≈$112 million. Recurrent TC was seen among 1.9% of patients readmitted within 6 months. Conclusions Though the overall rate of 1‐month readmission following TC is low, associated economic burden from readmission is still significant. Patients are readmitted mostly for noncardiac causes. Readmission for another episode of TC within 6 months was uncommon.