Temporal Trends and Patient Characteristics Associated with 30-Day Hospital Readmission Rates after a First Acute Myocardial Infarction.
Age Factors
Aged
Atrial Fibrillation
/ epidemiology
Female
Heart Failure
/ epidemiology
Humans
Male
Massachusetts
/ epidemiology
Medical Records, Problem-Oriented
/ statistics & numerical data
Multiple Chronic Conditions
/ epidemiology
Myocardial Infarction
/ mortality
Needs Assessment
Patient Readmission
/ trends
Risk Assessment
Risk Factors
Acute myocardial infarction
Hospital readmissions
Journal
The American journal of medicine
ISSN: 1555-7162
Titre abrégé: Am J Med
Pays: United States
ID NLM: 0267200
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
04
03
2021
accepted:
05
03
2021
pubmed:
18
4
2021
medline:
10
9
2021
entrez:
17
4
2021
Statut:
ppublish
Résumé
Limited data exist about relatively recent trends in the magnitude and characteristics of patients who are re-hospitalized after hospital admission for an acute myocardial infarction. This study examined trends in the frequency and sociodemographic and clinical characteristics of patients readmitted to the hospital within 30 days after an initial acute myocardial infarction. We reviewed the medical records of 3116 individuals who were hospitalized for a validated first acute myocardial infarction in 6 study periods between 2003 and 2015 at the 3 major medical centers in central Massachusetts. The median age of our population was 67 years, and 42% were women. The risk of being readmitted to the hospital within 30 days after an initial acute myocardial infarction increased slightly during the most recent study years after controlling for potentially confounding factors. Overall, older adults and patients with previously diagnosed atrial fibrillation, heart failure, diabetes, chronic kidney disease, stroke, and peripheral vascular disease were at higher risk for being readmitted to the hospital than respective comparison groups. For those hospitalized in the most recent study years of 2011/2015, a higher risk of rehospitalization was associated with a previous diagnosis of chronic kidney disease, peripheral vascular disease, the presence of 3 or more chronic conditions, and having developed atrial fibrillation or heart failure during the patient's hospitalization for a first acute myocardial infarction. We identified several groups at higher risk for hospital readmission in whom enhanced surveillance efforts as well as tailored educational and treatment approaches remain needed.
Sections du résumé
BACKGROUND
Limited data exist about relatively recent trends in the magnitude and characteristics of patients who are re-hospitalized after hospital admission for an acute myocardial infarction. This study examined trends in the frequency and sociodemographic and clinical characteristics of patients readmitted to the hospital within 30 days after an initial acute myocardial infarction.
METHODS
We reviewed the medical records of 3116 individuals who were hospitalized for a validated first acute myocardial infarction in 6 study periods between 2003 and 2015 at the 3 major medical centers in central Massachusetts.
RESULTS
The median age of our population was 67 years, and 42% were women. The risk of being readmitted to the hospital within 30 days after an initial acute myocardial infarction increased slightly during the most recent study years after controlling for potentially confounding factors. Overall, older adults and patients with previously diagnosed atrial fibrillation, heart failure, diabetes, chronic kidney disease, stroke, and peripheral vascular disease were at higher risk for being readmitted to the hospital than respective comparison groups. For those hospitalized in the most recent study years of 2011/2015, a higher risk of rehospitalization was associated with a previous diagnosis of chronic kidney disease, peripheral vascular disease, the presence of 3 or more chronic conditions, and having developed atrial fibrillation or heart failure during the patient's hospitalization for a first acute myocardial infarction.
CONCLUSIONS
We identified several groups at higher risk for hospital readmission in whom enhanced surveillance efforts as well as tailored educational and treatment approaches remain needed.
Identifiants
pubmed: 33864760
pii: S0002-9343(21)00237-0
doi: 10.1016/j.amjmed.2021.03.024
pmc: PMC8410623
mid: NIHMS1693924
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1127-1134Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL035434
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG062630
Pays : United States
Organisme : NIA NIH HHS
ID : R33 AG057806
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL120823
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL105268
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
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