Trends in the Magnitude of, and Patient Characteristics Associated With, Multiple Hospital Readmissions After Acute Myocardial Infarction.
Trends in the Magnitude of, and Patient Characteristics Associated With, Multiple Hospital Readmissions After Acute Myocardial Infarction.
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急性心肌梗死后多次再入院的程度和患者特征的趋势。
DOI：
10.1016/j.amjcard.2016.07.028
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Goldberg,RobertJ
中科院分区：
文献类型：
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作者：
Tisminetzky,Mayra;Chen,Han-Yang;McManus,DavidD;Gurwitz,Jerry;Granillo,Edgard;Yarzebski,Jorge;Gore,JoelM;Goldberg,RobertJ
关于急性心肌梗死（AMI）出院后多次再住院患者的规模和特征的近期趋势，目前可用的数据有限。我们回顾了马萨诸塞州伍斯特市大都会区的4480名居民的医疗记录，他们在2001年至2011年的6个两年期间从马萨诸塞州中部的3个医疗中心出院，并在随后的6个月内随访了所有原因和特定原因的再入院情况。我们研究人群的平均年龄为68岁，89%为白人，41%为女性。总体而言，每3名患者中就有1名在AMI出院后6个月内再次入院。在研究期间，6个月内因任何原因再次入院1、2或3次的患者比例保持不变（分别为20%、8%和6%）；59%的再入院与心脏有关。女性、老年患者、多重慢性疾病患者、指数住院时间延长的患者以及住院期间发生心力衰竭和/或房颤的患者多次再入院的风险高于一次再入院的患者。AMI出院后6个月的再入院率在研究期间保持稳定。总之，我们确定了几个多次再入院风险较高的群体，他们可能是加强监测工作和量身定制教育和治疗方法的目标。
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.