Leaving a cardiology service against medical advice.

In an exploratory retrospective study of 64 hospitalized patients, we examined the demographic, medical, and psychologic correlates in patients who left our Cardiology Service against medical advice (AMA). Based on a medical chart review, the AMA and control groups were found to be significantly different regarding prior cardiac disability level, physical signs of chronic alcohol abuse on admission, cardiac complications, and requirement of antihypertensive/diuretic medications while hospitalized. The two groups were also significantly different with regard to somatic complaints, apparent anxiety and use of psychotropic medication on the day before leaving against medical advice. This study indicates that a multifactorial assessment of patients hospitalized on a cardiology service can enhance identification of those at risk to leave the hospital against medical advice.