Department of Population and Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine
Cardiology | Cardiovascular Diseases | Epidemiology | Health Information Technology | Health Services Research | Pain Management | Pathological Conditions, Signs and Symptoms
BACKGROUND: Patients with acute coronary syndromes often experience non-specific (generic) pain after hospital discharge. However, evidence about the association between post-discharge non-specific pain and rehospitalization remains limited.
METHODS: We analyzed data from the Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) prospective cohort. TRACE-CORE followed patients with acute coronary syndromes for 24 months post-discharge from the index hospitalization, collected patient-reported generic pain (using SF-36) and chest pain (using the Seattle Angina Questionnaire) and rehospitalization events. We assessed the association between generic pain and 30-day rehospitalization using multivariable logistic regression (N = 787). We also examined the associations among patient-reported pain, pain documentation identified by natural language processing (NLP) from electronic health record (EHR) notes, and the outcome.
RESULTS: Patients were 62 years old (SD = 11.4), with 5.1% Black or Hispanic individuals and 29.9% women. Within 30 days post-discharge, 87 (11.1%) patients were re-hospitalized. Patient-reported mild-to-moderate pain, without EHR documentation, was associated with 30-day rehospitalization (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.14-3.62, reference: no pain) after adjusting for baseline characteristics; while patient-reported mild-to-moderate pain with EHR documentation (presumably addressed) was not (OR: 1.23, 95% CI: 0.52-2.90). Severe pain was also associated with 30-day rehospitalization (OR: 3.16, 95% CI: 1.32-7.54), even after further adjusting for chest pain (OR: 2.59, 95% CI: 1.06-6.35).
CONCLUSIONS: Patient-reported post-discharge generic pain was positively associated with 30-day rehospitalization. Future studies should further disentangle the impact of cardiac and non-cardiac pain on rehospitalization and develop strategies to support the timely management of post-discharge pain by healthcare providers.
Acute coronary syndrome, Cardiovascular disease, Care transition, Electronic health records, Natural language processing, Non-specific pain, Readmission
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DOI of Published Version
Chen J, Kiefe CI, Gagnier M, Lessard D, McManus D, Wang B, Houston TK. Non-specific pain and 30-day readmission in acute coronary syndromes: findings from the TRACE-CORE prospective cohort. BMC Cardiovasc Disord. 2021 Aug 9;21(1):383. doi: 10.1186/s12872-021-02195-z. PMID: 34372783; PMCID: PMC8351351. Link to article on publisher's site
BMC cardiovascular disorders
Chen J, Kiefe CI, Gagnier M, Lessard DM, McManus DD, Wang B, Houston TK. (2021). Non-specific pain and 30-day readmission in acute coronary syndromes: findings from the TRACE-CORE prospective cohort. Population and Quantitative Health Sciences Publications. https://doi.org/10.1186/s12872-021-02195-z. Retrieved from https://escholarship.umassmed.edu/qhs_pp/1415
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This work is licensed under a Creative Commons Attribution 4.0 License.
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