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. 2018 May 29;137(22):2332-2339.
doi: 10.1161/CIRCULATIONAHA.117.032086. Epub 2018 Mar 10.

Hospital Readmission After Perioperative Acute Myocardial Infarction Associated With Noncardiac Surgery

Nathaniel R Smilowitz  1 , Joshua A Beckman  2 , Scott E Sherman  3   4 , Jeffrey S Berger  5   6
Affiliations

Hospital Readmission After Perioperative Acute Myocardial Infarction Associated With Noncardiac Surgery

Nathaniel R Smilowitz et al. Circulation. .

Abstract

Background: Acute myocardial infarction (AMI) is a major cardiovascular complication of noncardiac surgery. We aimed to evaluate the frequency, causes, and outcomes of 30-day hospital readmission after perioperative AMI.

Methods: Patients who were diagnosed with AMI during hospitalization for major noncardiac surgery were identified using the 2014 US Nationwide Readmission Database. Rates, causes, and costs of 30-day readmissions after noncardiac surgery with and without perioperative AMI were identified.

Results: Among 3 807 357 hospitalizations for major noncardiac surgery, 8085 patients with perioperative AMI were identified. A total of 1135 patients (14.0%) with perioperative AMI died in-hospital during the index admission. Survivors of perioperative AMI were more likely to be readmitted within 30 days than surgical patients without perioperative AMI (19.1% versus 6.5%, P<0.001). The most common indications for 30-day rehospitalization were management of infectious complications (30.0%), cardiovascular complications (25.3%), and bleeding (10.4%). In-hospital mortality during hospital readmission in the first 30 days after perioperative AMI was 11.3%. At 6 months, the risk of death was 17.6% and ≥1 hospital readmission was 36.2%.

Conclusions: Among patients undergoing noncardiac surgery who develop a perioperative MI, ≈1 in 3 suffer from in-hospital death or hospital readmission in the first 30 days after discharge. Strategies to improve outcomes of surgical patients early after perioperative AMI are warranted.

Keywords: acute coronary syndrome; hospital readmission; myocardial infarction; noncardiac surgery; perioperative; readmission; surgery.

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Conflict of interest statement

Conflict of Interest Disclosures: None.

Figures

Figure 1
Figure 1
Surgery specific risks for in-hospital death during the index hospitalization or 30-day hospital readmission among patients with perioperative AMI
See this image and copyright information in PMC

Comment in

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