title: Long-term mortality and hospital readmission after acute myocardial infarction: an eight-year follow-up study.
abstract: OBJECTIVE
  Acute myocardial infarction is responsible for most of the deaths in developed countries and for a very large number of hospital admissions. Specifically in Spain, each year about 140,000 deaths and 5 million hospital stays are due to acute myocardial infarction, corresponding to health care costs reaching 15% of total expenditure. Therefore, this paper presents an exhaustive analysis of acute myocardial infarction and the related prognosis, such as recurrence and mortality.
  
  
  METHODS
  This observational study was carried out in Spain. Data were obtained using the Hospital Discharge Administrative Database from 2000 through 2007, inclusive. Specifically, 12,096 cases of acute myocardial infarction (8606 women and 3490 men) were reported during this period, with 2395 readmissions for this diagnosis. Readmissions were analyzed for frequency and duration using logistic regression and the Wang survival model. Mortality was analyzed using logistic regression.
  
  
  RESULTS
  Readmission rates were 50% for patients younger than 45 years and 38% for those older than 75 years (P<.001). Men were readmitted more frequently than women throughout the follow-up period. Variables related to hospital mortality from acute myocardial infarction were the presence of diabetes, previous ischemic heart disease, and cerebrovascular disease.
  
  
  CONCLUSIONS
  Mid-term hospital readmissions are highly frequent in acute myocardial infarction survivors. Male sex, previous coronary heart disease, and the number of classical cardiovascular risk factors are the major risk predictors of this readmission. Our results highlight the need for improved medical care during acute myocardial infarction admission, integrated into secondary prevention programs.
authors: Instituto de Investigación 12 de Octubre (i+12), CIBER de Epidemiología y Salud Pública, Madrid, Spain. eandres@h12o.es
authors: Eva
authors: E
authors: Andrés
authors: Alberto
authors: A
authors: Cordero
authors: Purificación
authors: P
authors: Magán
authors: Eduardo
authors: E
authors: Alegría
authors: Montserrat
authors: M
authors: León
authors: Emilio
authors: E
authors: Luengo
authors: Rosa Magallón
authors: RM
authors: Botaya
authors: Luis
authors: L
authors: García Ortiz
authors: José A
authors: JA
authors: Casasnovas
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011379:Prognosis; D011787:Quality of Health Care; D012008:Recurrence; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis