title: Trends in the Magnitude of, and Patient Characteristics Associated With, Multiple Hospital Readmissions After Acute Myocardial Infarction.
abstract: There are limited contemporary data available describing recent trends in the magnitude and characteristics of patients who are rehospitalized multiple times after hospital discharge for an acute myocardial infarction (AMI). We reviewed the medical records of 4,480 residents of the Worcester, Massachusetts, metropolitan area, who were discharged from 3 Central Massachusetts medical centers after an AMI in 6 biennial periods from 2001 to 2011 and were followed for all-cause and cause-specific hospital readmissions over the subsequent 6 months. The average age of our study population was 68 years, 89% were white, and 41% were women. Overall, ∼1 of every 3 patients had a readmission to the hospital within 6 months after hospital discharge for an AMI. The proportion of patients who were readmitted to the hospital 1, 2, or 3 times for any cause within 6 months remained unchanged during the years under study (20%, 8%, and 6%, respectively); 59% of these readmissions were cardiac related. Women, elderly patients, those with multiple chronic conditions, patients with a prolonged index hospitalization, and those who developed heart failure and/or atrial fibrillation during hospitalization were at higher risk for being readmitted multiple times compared with those who were readmitted once. Six-month hospital readmission rates after hospital discharge for an AMI remained stable during the years under study. In conclusion, we identified several groups at higher risk for multiple hospital readmissions who might be targeted for intensified monitoring efforts and tailored educational and treatment approaches.
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts; Division of Geriatrics, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Mayra
authors.initials: M
authors.lastname: Tisminetzky
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Han-Yang
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts; Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: David D
authors.initials: DD
authors.lastname: McManus
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts; Division of Geriatrics, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Jerry
authors.initials: J
authors.lastname: Gurwitz
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Edgard
authors.initials: E
authors.lastname: Granillo
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Jorge
authors.initials: J
authors.lastname: Yarzebski
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gore
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts; Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: kelley.baron@umassmed.edu.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology*; D010359:Patient Readmission / Q000706:statistics & numerical data / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors