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Unplanned Rehospitalizations After Acute MI
Study Questions:
What are the predictors of rehospitalization in patients discharged alive after a myocardial infarction (MI)?
Methods:
The authors examined the predictors of unplanned rehospitalizations (inpatient or observation status) within 30 days post-discharge in patients with MI treated with percutaneous coronary intervention at 233 hospitals in the TRANSLATE-ACS study.
Results:
The study population was comprised of 12,312 patients, of whom 1,326 (10.8%) had 1,483 unplanned rehospitalizations within 30 days of the index event. Of these, the majority 1,028 (69.3%) were in-patient readmissions, and 455 (30.7%) were observation stays. Cardiovascular disease was the leading cause of unplanned rehospitalizations (72%). The median hospital rate of 30-day unplanned rehospitalization was 10.7% (range, 5.4-20.0%). The strongest predictors of unplanned rehospitalization were baseline quality of life and depression, followed by index hospital length of stay.
Conclusions:
Rehospitalization is common in patients with MI, and is strongly impacted by overall measures of health and quality of life.
Perspective:
This study adds to the growing body of data on rehospitalization after MI. It is interesting that a third of re-admissions were for noncardiovascular causes and that the strongest predictors of rehospitalization were baseline quality of life and depression. Efforts to reduce rehospitalization need to focus on functional status and social factors in addition to optimizing cardiovascular care.
Keywords: Acute Coronary Syndrome, Depression, Inpatients, Myocardial Infarction, Patient Readmission, Percutaneous Coronary Intervention, Quality of Life
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