Abstract
Introduction: Acute myocardial infarction (MI) is a leading cause of morbidity and mortality worldwide. Despite advances in treatment, readmissions within 30 days remain a significant concern, impacting both patient outcomes and healthcare costs. This study aims to analyze trends in 30-day readmission rates (30-dr) for patients discharged after an acute MI. Methods: We analyzed the 2016-2020 Nationwide Readmission Database for patients aged ≥ 18 years with initial admission of acute MI and were readmitted within 30 days. Variables were identified using ICD-10 codes. The primary outcome was trends in 30-dr; secondary outcomes included trends in complications, mortality rate, length of stay (LOS), and healthcare costs. Multivariate and descriptive bivariate analyses were conducted, with p-values <0.05 considered statistically significant. Results: There was a notable decrease in the acute MI index admissions total number from 507,608 in 2016 to 471,292, p trend < 0.01. The index admission mean age throughout the study years was 66.9 ± 13.5 years, with 62.7% male patient. Index admission inpatient mortality dropped reaching OR 0.92 (CI 0.88-0.96) by 2020 with a drop of 0.08 OR from 2016 with (p trend < 0.01) using logistic regression. The index admission LOS remained consistent with allover average 4.64 days (p trend = 0.25). The mean healthcare costs saw a significant increase from $22,456 in 2016 to $27,249 in 2020 (p trend < 0.01). The 30-dr trend decreased from 9.41% in 2016 to 7.8% in 2020 (p trend < 0.01). The top five readmission reasons in order included heart failure (14.94%of total readmission), myocardial reinfarction (13.59%), sepsis (4.49%), Acute kidney injury(2.4%), and chest pain(2.1%). The risk of readmission went up 1% for each year increase of age and 12% for female gender (using OR,logistic regression), despite initial admission was more male dominant. Conclusion: Our study demonstrates a declining initial admission, its mortality rate,and 30-dr. There was readmission healthcare costs increase. We noticed four top complications-driven readmission falling under cardiovascular diseases category with the top one as heart failure and myocardial reinfarction. This study tries to highlight relevant data to target interventions to reduce readmissions and complications, ultimately improving patient outcomes and reducing the healthcare economic burden.
Published Version
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