Department of Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine; Meyers Primary Care Institute
Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Epidemiology | Health Services Research
BACKGROUND: There are limited data available describing relatively contemporary trends in 30-day rehospitalizations among patients who survive hospitalization after an acute myocardial infarction (AMI) in the community setting. We examined decade-long (2001-2011) trends in, and factors associated with, 30-day rehospitalizations in patients discharged from 3 central Massachusetts hospitals after AMI.
METHODS AND RESULTS: Residents of the Worcester, MA, metropolitan area discharged after AMI from 3 central Massachusetts hospitals on a biennial basis between 2001 and 2011 comprised the study population (N=4810). Logistic regression analyses were used to examine the association between selected factors and 30-day rehospitalizations. The average age of this population was 69 years, 42% were women, and 92% were white. During the years under study, 18.5% of patients were rehospitalized within 30 days after hospital discharge. Crude 30-day rehospitalization rates decreased from 20.5% in 2001-2003 to 15.8% in 2009-2011. After adjusting for several patient characteristics, there was a reduced odds of being rehospitalized in 2009-2011 (odds ratio 0.74, 95% CI 0.61-0.91) compared with 2001-2003; this trend was slightly attenuated after further adjustment for hospital treatment practices. Female sex, having previously diagnosed heart failure and chronic kidney disease, and the development of in-hospital cardiogenic shock and heart failure were associated with an increased odds of being rehospitalized.
CONCLUSIONS: While the likelihood of subsequent short-term rehospitalizations remained frequent, we observed an encouraging decline during the most recent years under study. Several high-risk groups were identified for purposes of heightened surveillance and intervention efforts to reduce the likelihood of being readmitted.
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Citation: J Am Heart Assoc. 2015 Nov 3;4(11). pii: e002291. doi: 10.1161/JAHA.115.002291. Link to article on publisher's site
Chen, Han-Yang; Tisminetzky, Mayra; Lapane, Kate L.; Yarzebski, Jorge L.; Person, Sharina D.; Kiefe, Catarina I.; Gore, Joel; and Goldberg, Robert J., "Decade-Long Trends in 30-Day Rehospitalization Rates After Acute Myocardial Infarction" (2015). Open Access Articles. 2673.
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