Discharge Against Medical Advice After Percutaneous Coronary Intervention in the United States

Al Shaibi, K; Gulati, R; Bell, M; Anderson, V; Potts, J; Rashid, M; Kontopantelis, E; Bagur, R; Mamas, M; Kwok, CS

doi:10.1016/j.jcin.2018.03.049

Discharge Against Medical Advice After Percutaneous Coronary Intervention in the United States

Al Shaibi, K; Gulati, R; Bell, M; Anderson, V; Potts, J; Rashid, M; Kontopantelis, E; Bagur, R; Mamas, M; Kwok, CS

Authors

K Al Shaibi

R Gulati

M Bell

V Anderson

Jessica Potts j.e.potts@keele.ac.uk

Muhammad Rashid m.rashid@keele.ac.uk

E Kontopantelis

R Bagur

Mamas Mamas m.mamas@keele.ac.uk

CS Kwok

Abstract

Discharge against medical advice (DAMA) in the context of PCI has not been described in the literature. Among the 2,021,104 patients, the proportion of patients who DAMA was 0.5% (n=10,049). Important predictors of DAMA included diagnosis of acute myocardial infarction, smoking, and alcohol misuse. DAMA was the strongest predictor for readmission
(OR 1.92, 1.74-2.12, p<0.001). DAMA patients were more likely to have neuropsychiatric reasons for non-cardiac causes of readmission and acute myocardial infarction for cardiac causes of readmission compared to patients discharged home. DAMA following PCI is rare but it is strongly associated with readmissions within 30 days.

Acceptance Date	Mar 20, 2018
Publication Date	Jul 16, 2018
Journal	JACC: Cardiovascular Interventions
Print ISSN	1876-7605
Pages	1354-1364
DOI	https://doi.org/10.1016/j.jcin.2018.03.049
Keywords	percutaneous coronary intervention, discharge against medical advice, readmissions
Publisher URL	http://doi.org/10.1016/j.jcin.2018.03.049