Readmission of Patients with Acute Coronary Syndrome and Determinants

Abstract

Background Acute coronary syndrome (ACS) is responsible for high rates of hospital admission and readmission, which are associated with increased costs for the patient and the health system, and increased in-hospital mortality rates. Objective To evaluate readmission in patients with ACS and its determinants. Methods This was a retrospective cohort study of adult and elderly patients with ACS, readmitted to public and private referral cardiology hospitals within one year after the first hospitalization for ACS. The occurrence of readmissions, the time elapsed from the first to the second admission, and the use of medications at admission were collected from the medical records. Associations between categorical variables were evaluated by the chi-square test or the Fisher's exact test. Multiple logistic regression was used to evaluate predictors for readmissions. A p < 0.05 was set as statistically significant. Results Readmission rate was 21.5% (n = 115) and mean time between admissions was 122.7 ± 112.1 days. The patients were mostly men (64.0%), mean age of 63.15 ± 12.3 years. Among readmitted patients, 7% had a prognosis of "death", and 68.7% were readmitted more than once within a one-year period. The main reasons of readmission were cardiovascular diseases including ACS. Private health care and the diagnosis of congestive heart failure were associated with multiple logistic regression. Conclusion ACS was the main cause of readmission, with higher prevalence among users of supplemental health care. Readmissions were associated with previous diagnosis of congestive heart failure and the type of health care provided.

Covid-19 no Brasil: Aprendendo a Andar no Escuro sem Deixar Nada para Trás

“…As of writing this, the number of deaths from Covid-19 in Brazil is about 10,000 patients and we have almost 45 days of isolation. Due to an expected 30% reduction in primary angioplasty surgeries, increased transfer times and rehospitalizations due to untreated acute coronary syndromes, [15][16][17] an excess of cardiovascular deaths of over 3,000 is estimated in this period. Missing outpatient visits of various specialties increases the risk of death by up to 1.5 times, adding to this excess another 9,000 unnecessary deaths.…”

Resposta a ‘’Reinternação de Pacientes com Síndrome Coronariana Aguda e seus Determinantes’’: Uma Visão da APS

“…O estudo de Oliveira et al, 1 mostra dados de suma importância sobre reinternações de pacientes em hospitais em até um ano após internação prévia por SCA e seus determinantes. Nesse estudo, foram avaliadas inúmeras variáveis, e entre as mais determinantes destaca-se o tipo de serviço de saúde utilizado pelos pacientes durante as internações.…”

“…The study by Oliveira et al 1 shows extremely important data on readmissions of patients within one year after hospitalization for ACS and its determinants. In their study, a number of variables were evaluated.…”

Hospital Readmissions after Acute Coronary Syndromes

“…In this issue, colleagues from Aracaju (Sergipe, Brazil) report the study 8 of a hospital-based sample of 536 eligible patients with acute coronary syndrome admitted to three private hospitals (where costs are usually paid by the patient or through an insurance group) and one public hospital (supported by the government, either city, state or federal government) to scrutinize variables associated with re-admissions. They observed the readmission rate was high (115/536, 21.4%) and the mortality of the readmitted patients was also high - 7%.…”

“…They observed the readmission rate was high (115/536, 21.4%) and the mortality of the readmitted patients was also high - 7%. Acute coronary syndromes and heart failure were the leading causes of hospital readmission, mainly in patients admitted to private hospital facilities, 8 probably related to characteristics of the access. The authors recognize that a hospital-based study sample without full follow-up data are limitations that may stimulate following the previous suggestion to remain vigilant 2 for health deterioration after discharge from in-hospital treatment, emphasizing the importance of continuous medical advice, support, and therapy.…”