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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Copyright 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
DOI of Published Version
J Am Heart Assoc. 2015 Nov 3;4(11). pii: e002291. doi: 10.1161/JAHA.115.002291. Link to article on publisher's site
Journal of the American Heart Association
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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This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License