Open AccessPredictors of Early (0-7 Days) and Late (8-30 Days) Readmission in a Cohort of Acute Coronary Syndrome Patients
Author(s) -
George Cholack,
Joshua Garfein,
Rachel Krallman,
Delaney Feldeisen,
Daniel Montgomery,
Eva KlineRogers,
Geoffrey D. Barnes,
Kim A. Eagle,
Melvyn Rubenfire,
Sherry Bumpus
Publication year - 2022
Publication title -
international journal of medical students
Language(s) - English
Resource type - Journals
ISSN - 2076-6327
DOI - 10.5195/ijms.2022.1058
Subject(s) - medicine , acute coronary syndrome , myocardial infarction , coronary care unit , unstable angina , heart failure , confidence interval , cohort , logistic regression , intensive care unit , atrial fibrillation , retrospective cohort study , cardiology , angina , population , environmental health
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.