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

Authors

  • George Cholack Medical student, MSc. Michigan Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI; Oakland University William Beaumont School of Medicine, Rochester, MI, United States https://orcid.org/0000-0001-6774-7326
  • Joshua Garfein MPH. Michigan Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States https://orcid.org/0000-0002-6884-9479
  • Rachel Krallman BS. Michigan Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States https://orcid.org/0000-0002-4466-7697
  • Delaney Feldeisen BA. Michigan Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States https://orcid.org/0000-0003-4204-9956
  • Daniel Montgomery BS. Michigan Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States https://orcid.org/0000-0002-4570-1391
  • Eva Kline-Rogers NP. Michigan Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States https://orcid.org/0000-0002-3245-7895
  • Geoffrey D. Barnes MD, MSc. Michigan Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States https://orcid.org/0000-0002-6532-8440
  • Kim Eagle MD. Michigan Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States https://orcid.org/0000-0003-0031-0191
  • Melvyn Rubenfire MD. Michigan Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States https://orcid.org/0000-0002-0290-7154
  • Sherry Bumpus PhD, FNP-BC. Michigan Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI; Eastern Michigan University, College of Health and Human Services, School of Nursing, Ypsilanti, MI, United States https://orcid.org/0000-0002-7812-5183

DOI:

https://doi.org/10.5195/ijms.2022.1058

Keywords:

Myocardial Infarction, Unstable angina, Atrial fibrilation, Intensive care unit, Heart failure, Patient readmission

Abstract

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.

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Published

2022-01-13 — Updated on 2022-04-05

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How to Cite

Cholack, G., Garfein, J., Krallman, R., Feldeisen, D., Montgomery, D., Kline-Rogers, E., Barnes, G. D., Eagle, K., Rubenfire, M., & Bumpus, S. (2022). Predictors of Early (0-7 Days) and Late (8-30 Days) Readmission in a Cohort of Acute Coronary Syndrome Patients. International Journal of Medical Students, 10(1), 38–48. https://doi.org/10.5195/ijms.2022.1058