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J Am Heart Assoc. 2015 Nov 3;4(11). pii: e002291. doi: 10.1161/JAHA.115.002291.

Decade-Long Trends in 30-Day Rehospitalization Rates After Acute Myocardial Infarction.

Author information

1
Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA (H.Y.C., M.T., K.L.L., J.Y., S.D.P., C.I.K., J.M.G., R.J.G.).
2
Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA (H.Y.C., M.T., K.L.L., J.Y., S.D.P., C.I.K., J.M.G., R.J.G.) Department of Medicine, University of Massachusetts Medical School, Worcester, MA (J.M.G.).
3
Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA (H.Y.C., M.T., K.L.L., J.Y., S.D.P., C.I.K., J.M.G., R.J.G.) Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA (R.J.G.).

Abstract

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.

KEYWORDS:

acute myocardial infarction; readmission; rehospitalization

PMID:
26534862
PMCID:
PMC4845213
DOI:
10.1161/JAHA.115.002291
[Indexed for MEDLINE]
Free PMC Article

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