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Observational Study
. 2015 Nov 3;4(11):e002291.
doi: 10.1161/JAHA.115.002291.

Decade-Long Trends in 30-Day Rehospitalization Rates After Acute Myocardial Infarction

Han-Yang Chen  1 , Mayra Tisminetzky  1 , Kate L Lapane  1 , Jorge Yarzebski  1 , Sharina D Person  1 , Catarina I Kiefe  1 , Joel M Gore  2 , Robert J Goldberg  3
Affiliations
Observational Study

Decade-Long Trends in 30-Day Rehospitalization Rates After Acute Myocardial Infarction

Han-Yang Chen et al. J Am Heart Assoc. .

Abstract

Background: There are limited data available describing relatively contemporary trends in 30-day rehospitalizations among patients who survive hospitalization after an acute myocardial infarction (AMI) in the community setting. We examined decade-long (2001-2011) trends in, and factors associated with, 30-day rehospitalizations in patients discharged from 3 central Massachusetts hospitals after AMI.

Methods and results: Residents of the Worcester, MA, metropolitan area discharged after AMI from 3 central Massachusetts hospitals on a biennial basis between 2001 and 2011 comprised the study population (N=4810). Logistic regression analyses were used to examine the association between selected factors and 30-day rehospitalizations. The average age of this population was 69 years, 42% were women, and 92% were white. During the years under study, 18.5% of patients were rehospitalized within 30 days after hospital discharge. Crude 30-day rehospitalization rates decreased from 20.5% in 2001-2003 to 15.8% in 2009-2011. After adjusting for several patient characteristics, there was a reduced odds of being rehospitalized in 2009-2011 (odds ratio 0.74, 95% CI 0.61-0.91) compared with 2001-2003; this trend was slightly attenuated after further adjustment for hospital treatment practices. Female sex, having previously diagnosed heart failure and chronic kidney disease, and the development of in-hospital cardiogenic shock and heart failure were associated with an increased odds of being rehospitalized.

Conclusions: While the likelihood of subsequent short-term rehospitalizations remained frequent, we observed an encouraging decline during the most recent years under study. Several high-risk groups were identified for purposes of heightened surveillance and intervention efforts to reduce the likelihood of being readmitted.

Keywords: acute myocardial infarction; readmission; rehospitalization.

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Figures

Figure 1
Figure 1
Rates of rehospitalizations within 30 days after hospital discharge among patients who survived an acute myocardial infarction: Worcester Heart Attack Study, 2001–2011 (n=4810).
Figure 2
Figure 2
Cause‐specific 30‐day rehospitalization rates after hospital discharge among patients who survived an AMI: Worcester Heart Attack Study, 2001–2011 (n=4810). AMI indicates acute myocardial infarction; CVD, cardiovascular diseases exclude AMI.
See this image and copyright information in PMC

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