Temporal Trends and Patient Characteristics Associated with 30-Day Hospital Readmission Rates after a First Acute Myocardial Infarction

Abstract

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.

MRI Investigation of the Differential Impact of Left Ventricular Ejection Fraction After Myocardial Infarction in Elderly vs. Nonelderly Patients to Predict Readmission for Heart Failure

“…[23][24][25] In 9406 STEMI patients between 2002 and 2008, Kaul et al found that 13.6% of the cohort developed AHF during the index hospitalization and a cumulative rate of 23.4% was noted at 1 year. 25 Other contemporary registries have shown similar AHF incidence after STEMI (9.9%-14.6%), [22][23][24] consistent with the incidence of this event in our cohort (10.4%).…”

“…22 In more contemporary registries, however, AHF occurrence has decreased, probably due to the adoption of urgent reperfusion strategies which can decrease the amount of irreversible myocardial damage. [23][24][25] In 9406 STEMI patients between 2002 and 2008, Kaul et al found that 13.6% of the cohort developed AHF during the index hospitalization and a cumulative rate of 23.4% was noted at 1 year. 25 Other contemporary registries have shown similar AHF incidence after STEMI (9.9%-14.6%), [22][23][24] consistent with the incidence of this event in our cohort (10.4%).…”

“…Irrespective of the timing of presentation, either during index admission (represented by the Killip class classification) or after hospital discharge, AHF development after STEMI associates with worse long-term prognosis, 9,10 including increased mortality during follow-up. [22][23][24] Given its impact on prognosis, the search for reliable predictors of AHF after STEMI is important to better allocate pharmacological, logistical, and personal resources in the follow-up of patients at higher risk.…”

“…Prior to the primary PCI era, AHF rates oscillated between 25% and 35% 22 . In more contemporary registries, however, AHF occurrence has decreased, probably due to the adoption of urgent reperfusion strategies which can decrease the amount of irreversible myocardial damage 23–25 . In 9406 STEMI patients between 2002 and 2008, Kaul et al found that 13.6% of the cohort developed AHF during the index hospitalization and a cumulative rate of 23.4% was noted at 1 year 25 .…”

Fe2O3@SiO2@Eu-MOF@Tb-MOF Core/Multishell Nanoparticles for the Fluorescence Sensing of Aspirin and Acute Myocardial Infarction Biomarkers

“…In the past few years, acute myocardial infarction (AMI) has deprived millions of people of their health. , When patients suffer AMI, the symptoms are breathing difficulty, nausea, faintness, breaking out in a cold sweat, and tiredness. If AMI cannot be recognized in time, heart failure, arrhythmias, cardiogenic shock, and cardiac arrest can occur in patients. − In time, the detection of AMI biomarkers should be given much more attention, mainly focusing on designing a fast, simple, and convenient detection method. Although aspirin is an effective curing drug for AMI, overuse of aspirin can cause profound side effects.…”