Mayra Tisminetzky1, Jordy Mehawej2, Ruben Miozzo3, Jerry H Gurwitz4, Joel M Gore5, Darleen Lessard6, Hawa O Abu7, Benita A Bamgbade8, Jorge Yarzebski6, Edgard Granillo6, Robert J Goldberg9. 1. Meyers Primary Care Institute, Worcester, Mass; Division of Geriatric Medicine; Department of Population and Quantitative Health Sciences. Electronic address: mayra.tisminetzky@umassmed.edu. 2. Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester. 3. Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. 4. Meyers Primary Care Institute, Worcester, Mass; Division of Geriatric Medicine; Department of Population and Quantitative Health Sciences. 5. Department of Population and Quantitative Health Sciences; Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester. 6. Department of Population and Quantitative Health Sciences. 7. Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester; Internal Medicine Department, Saint Vincent Hospital, Worcester, Mass. 8. Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Northeastern University, Boston, Mass. 9. Meyers Primary Care Institute, Worcester, Mass; Department of Population and Quantitative Health Sciences.
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.
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.
Authors: Jeptha P Curtis; Geoffrey Schreiner; Yongfei Wang; Jersey Chen; John A Spertus; John S Rumsfeld; Ralph G Brindis; Harlan M Krumholz Journal: J Am Coll Cardiol Date: 2009-09-01 Impact factor: 24.094
Authors: Patrick T O'Gara; Frederick G Kushner; Deborah D Ascheim; Donald E Casey; Mina K Chung; James A de Lemos; Steven M Ettinger; James C Fang; Francis M Fesmire; Barry A Franklin; Christopher B Granger; Harlan M Krumholz; Jane A Linderbaum; David A Morrow; L Kristin Newby; Joseph P Ornato; Narith Ou; Martha J Radford; Jacqueline E Tamis-Holland; Carl L Tommaso; Cynthia M Tracy; Y Joseph Woo; David X Zhao Journal: J Am Coll Cardiol Date: 2012-12-17 Impact factor: 24.094
Authors: Hani Jneid; Jeffrey L Anderson; R Scott Wright; Cynthia D Adams; Charles R Bridges; Donald E Casey; Steven M Ettinger; Francis M Fesmire; Theodore G Ganiats; A Michael Lincoff; Eric D Peterson; George J Philippides; Pierre Theroux; Nanette K Wenger; James Patrick Zidar Journal: J Am Coll Cardiol Date: 2012-07-16 Impact factor: 24.094
Authors: John A Dodson; Alexandra M Hajduk; Terrence E Murphy; Mary Geda; Harlan M Krumholz; Sui Tsang; Michael G Nanna; Mary E Tinetti; David Goldstein; Daniel E Forman; Karen P Alexander; Thomas M Gill; Sarwat I Chaudhry Journal: Circ Cardiovasc Qual Outcomes Date: 2019-05
Authors: Shannon M Dunlay; Susan A Weston; Jill M Killian; Malcolm R Bell; Allan S Jaffe; Véronique L Roger Journal: Ann Intern Med Date: 2012-07-03 Impact factor: 25.391
Authors: Gregory W Yost; Stefanie L Puher; Jove Graham; Thomas D Scott; Kimberly A Skelding; Peter B Berger; James C Blankenship Journal: JACC Cardiovasc Interv Date: 2013-03 Impact factor: 11.195
Authors: Kevin C Floyd; Jorge Yarzebski; Frederick A Spencer; Darleen Lessard; James E Dalen; Joseph S Alpert; Joel M Gore; Robert J Goldberg Journal: Circ Cardiovasc Qual Outcomes Date: 2009-03-05
Authors: Vu Hoang Tran; Jordy Mehawej; Donna M Abboud; Mayra Tisminetzky; Essa Hariri; Andreas Filippaios; Joel M Gore; Jorge Yarzebski; Jordan H Goldberg; Darleen Lessard; Robert Goldberg Journal: J Am Heart Assoc Date: 2022-08-24 Impact factor: 6.106