Decade-Long Trends in the Frequency of 90-Day Rehospitalizations After Hospital Discharge for Acute Myocardial Infarction
| Autor: | Han-Yang Chen, Robert J. Goldberg, Jorge D. Yarzebski, Joel M. Gore, Mayra Tisminetzky |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Time Factors Population Myocardial Infarction 030204 cardiovascular system & hematology Patient Readmission Article 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Humans Medicine Hospital Mortality 030212 general & internal medicine Myocardial infarction education Survival rate Aged Retrospective Studies Aged 80 and over education.field_of_study business.industry Cardiogenic shock Retrospective cohort study Atrial fibrillation Length of Stay Middle Aged medicine.disease Patient Discharge Survival Rate Massachusetts Relative risk Emergency medicine Cardiology Population study Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The American Journal of Cardiology. 117:743-748 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2015.12.006 |
| Popis: | There are limited data available describing relatively contemporary trends in 90-day rehospitalizations among patients who survive hospitalization after an acute myocardial infarction (AMI) in a community setting. We examined decade-long (2001–2011) trends in, and factors associated with, 90-day rehospitalizations in patients discharged from three central Massachusetts (MA) hospitals after AMI. Residents of the Worcester, MA, metropolitan area discharged after AMI from three central MA hospitals on a biennial basis between 2001 and 2011 comprised the study population (n=4,810). The average age of this population was 69 years, 42% were women, and 92% were white. Between 2001 and 2011, 30.0% of patients were rehospitalized within 90 days after hospital discharge, and 38% of 90-day rehospitalizations occurred after the first month post hospital discharge. Crude 90-day rehospitalization rates decreased from 31.5% in 2001/2003 to 27.3% in 2009/2011. After adjusting for several sociodemographic characteristics, comorbidities, and in-hospital factors, there was a reduced risk of being rehospitalized within 90 days after hospital discharge in 2009/2011 compared with 2001/2003 (risk ratio (RR)=0.87, 95% confidence interval (CI)=0.77 to 0.98); this trend was slightly attenuated (RR=0.90, 95% CI=0.79 to 1.02) after further adjustment for hospital treatment practices. Female sex, having several previously diagnosed comorbidities, an increased hospital stay, and the in-hospital development of atrial fibrillation, cardiogenic shock, and heart failure were significantly associated with an increased risk of being rehospitalized. In conclusion, the likelihood of subsequent 90-day rehospitalizations remained frequent, and we did not observe a significant decline in these rates during the years under study. |
| Databáze: | OpenAIRE |
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