Kwok, CS ORCID: https://orcid.org/0000-0001-7047-1586, Wong, CW, Shufflebotham, H, Brindley, L, Fatima, T, Shufflebotham, A, Barker, D, Patwala, A, Heatlie, G and Mamas, MA ORCID: https://orcid.org/0000-0001-9241-8890 (2017) Early Readmissions After Acute Myocardial Infarction. American Journal of Cardiology, 120 (5). pp. 723-728.

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Abstract

This study aims to evaluate the rate, predictors, and causes of 30-day readmissions in a single tertiary hospital in the United Kingdom. We conducted a retrospective study of all patients admitted between 2012 and 2014 with a diagnosis of acute myocardial infarction, who were in the Myocardial Infarction National Audit Project register. Data on patient demographics, comorbidities, care received, and in-hospital mortality were collected. Rates of 30-day readmission and causes of readmission were evaluated. Univariate and multiple logistic regressions were used to identify predictors of all-cause, cardiac, and noncardiac readmission. A total of 1,869 patients were included in the analysis and 171 had an unplanned readmission with 30 days (9%). Noncardiac problems represented half of all readmissions with the dominant cause noncardiac chest pain (50%). A variety of other noncardiac causes for readmission were identified and the most common were lower respiratory tract infection (4.3%), gastrointestinal problems (4.9%), bleeding (3.7%), dizziness, syncope, or fall (3.0%), and pulmonary embolus (2.4%). For cardiac causes of readmissions, common causes included acute coronary syndrome (17.1%), stable angina (11.6%), and heart failure (9.8%). Readmitted patients were more likely to be older, anemic, and less likely to receive coronary angiogram and percutaneous coronary intervention. After adjustment, the only predictor of all-cause readmission was older age. For noncardiac readmission, previous myocardial infarction was associated with significantly fewer readmissions. Our results suggest that early readmission after discharge with diagnosis of acute myocardial infarction is common. Chest pain is the most frequent cause of readmission, and interventions to reduce noncardiac chest pain admissions are needed.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at https://doi.org/10.1016/j.amjcard.2017.05.049 Please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: myocardial infarction; readmissions
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Institute for Applied Clinical Sciences
Depositing User: Symplectic
Date Deposited: 08 Jun 2017 15:03
Last Modified: 20 Mar 2019 09:30
URI: http://eprints.keele.ac.uk/id/eprint/3566

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