Predictors of Early (0-7 Days) and Late (8-30 Days) Readmission in a Cohort of Acute Coronary Syndrome Patients

• Main Authors: George Cholack (Author), Joshua Garfein (Author), Rachel Krallman (Author), Delaney Feldeisen (Author), Daniel Montgomery (Author), Eva Kline-Rogers (Author), Geoffrey D. Barnes (Author), Kim Eagle (Author), Melvyn Rubenfire (Author), Sherry Bumpus (Author)
• Format: Book
• Published: University Library System, University of Pittsburgh, 2022-04-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.5195/ijms.2022.1058; 2076-6327
• Keywords: Myocardial Infarction; Unstable angina; Atrial fibrilation; Intensive care unit; Heart failure; Patient readmission; Medicine (General); R5-920; Public aspects of medicine; RA1-1270
• Source: International Journal of Medical Students, Vol 10, Iss 1 (2022)

Background: Readmissions following acute coronary syndrome are unevenly distributed across the 30-day post-discharge period. There is limited data on predictors of all-cause readmission in early (0-7 day) and late (8-30 day) post-discharge periods for this population; the purpose of this retrospective cohort study was to identify predictors of early and late readmission. Methods: Patients at Michigan Medicine (Ann Arbor, Michigan, United States) with a principal discharge diagnosis of unstable angina, ST-segment elevation myocardial infarction, or non-ST segment elevation myocardial infarction between April 2008 and November 2017 were identified. Predictors of early and late readmission were analyzed with multivariable logistic regression models. Results: Of 1120 patients hospitalized following acute coronary syndrome, 198 (17.68%) were readmitted within 30 days while 70 (6.25%) were readmitted within 7 days of discharge. Of 30-day readmissions, early readmissions were more likely in females [OR 2.26, 95% confidence interval (CI) 1.23, 4.16], non-white individuals (p=0.05), or patients requiring intensive care unit admission during hospitalization (OR 2.20, 95% CI 1.14, 4.24). Relative to patients not readmitted within 7 days, patients who were female, had history of atrial fibrillation, principal discharge diagnosis of non-ST segment elevation myocardial infarction, or required intensive care unit admission were more likely readmitted early. History of congestive heart failure was a predictor of late readmission when compared to patients not readmitted in 30 days. Conclusion: Following acute coronary syndrome, predictors of readmission varied between early and late readmission groups. Readmission predictors provides healthcare providers with information useful in minimizing readmissions and concomitant financial penalties.